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Computer tomography view showing air in the frontal region of the cranial cavity. | gox-2-e273-g001 | 7 | 85f5a7c78b9cb62590d6031f2d6e911304b610f0f12c37d32463851542c369d0 | gox-2-e273-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
858
] | [{'image_id': 'gox-2-e273-g002', 'image_file_name': 'gox-2-e273-g002.jpg', 'image_path': '../data/media_files/PMC4292255/gox-2-e273-g002.jpg', 'caption': 'Computer tomography view showing air in the temporal region of the cranial cavity.', 'hash': 'e3f3fb803e55e7d5c034cc958f7c9e1be42ac9313620454749cbf4b433cd7679'}, {'image_id': 'gox-2-e273-g001', 'image_file_name': 'gox-2-e273-g001.jpg', 'image_path': '../data/media_files/PMC4292255/gox-2-e273-g001.jpg', 'caption': 'Computer tomography view showing air in the frontal region of the cranial cavity.', 'hash': '85f5a7c78b9cb62590d6031f2d6e911304b610f0f12c37d32463851542c369d0'}] | {'gox-2-e273-g001': ['Four days postoperatively, she was presented to emergency room with complaints of frontal headache. She gave history of cough and excessive sneezing from second postoperative day. The Emergency Room physician examined her and saw no obvious reason for headache except the Silastic nasal splints. He advised her stronger pain medication and asked her to return if there was no improvement. The patient returned the following day with unbearable headache, 2 attacks of projectile vomiting. No fever, visual problems, nasal discharge, postnasal drip, or other neurological complaints. Her Silastic sheets were removed, emergency computer tomography scan was done showing frontal lobe pneumocephalus (Figs. <xref ref-type="fig" rid="gox-2-e273-g001">1</xref>, , <xref ref-type="fig" rid="gox-2-e273-g002">2</xref>), and emergency neurosurgical consult was taken, who decided to place a lumbar drain. The patient was admitted under the neurosurgery care and a lumbar drain was put and she was placed in semirecumbent position. No CSF leak was seen on diagnostic endoscopic examination.), and emergency neurosurgical consult was taken, who decided to place a lumbar drain. The patient was admitted under the neurosurgery care and a lumbar drain was put and she was placed in semirecumbent position. No CSF leak was seen on diagnostic endoscopic examination.']} | A Rare Complication of Septorhinoplasty | null | Plast Reconstr Surg Glob Open | 1420704000 | Although ADP release is the rate limiting step in product turnover by protein kinase A, the steps and motions involved in this process are not well resolved. Here we report the apo and ADP bound structures of the myristylated catalytic subunit of PKA at 2.9 and 3.5 Å resolution, respectively. The ADP bound structure adopts a conformation that does not conform to the previously characterized open, closed, or intermediate states. In the ADP bound structure, the C-terminal tail and Gly-rich loop are more closed than in the open state adopted in the apo structure but are also much more open than the intermediate or closed conformations. Furthermore, ADP binds at the active site with only one magnesium ion, termed Mg2 from previous structures. These structures thus support a model where ADP release proceeds through release of the substrate and Mg1 followed by lifting of the Gly-rich loop and disengagement of the C-terminal tail. Coupling of these two structural elements with the release of the first metal ion fills in a key step in the catalytic cycle that has been missing and supports an ensemble of correlated conformational states that mediate the full catalytic cycle for a protein kinase. | [
"Catalysis",
"Crystallization",
"Cyclic AMP-Dependent Protein Kinases",
"Protein Structure, Secondary",
"Protein Structure, Tertiary",
"Protein Subunits"
] | other | PMC4292255 | null | 45 | [
"{'Citation': 'Manning G.; Whyte D. B.; Martinez R.; Hunter T.; Sudarsanam S. (2002) The protein kinase complement of the human genome. Science 298, 1912–1934.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12471243'}}}",
"{'Citation': 'Johnson D. A.; Akamine P.; Radzio-Andzelm E.; Madhusudan M.; Taylor S. S. (2001) Dynamics of cAMP-dependent protein kinase. Chem. Rev. 101, 2243–2270.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11749372'}}}",
"{'Citation': 'Kim C.; Cheng C. Y.; Saldanha S. A.; Taylor S. S. (2007) PKA-I holoenzyme structure reveals a mechanism for cAMP-dependent activation. Cell 130, 1032–1043.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17889648'}}}",
"{'Citation': 'Knighton D. R.; Zheng J. H.; Ten Eyck L. F.; Xuong N. H.; Taylor S. S.; Sowadski J. M. (1991) Structure of a peptide inhibitor bound to the catalytic subunit of cyclic adenosine monophosphate-dependent protein kinase. Science 253, 414–420.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1862343'}}}",
"{'Citation': 'Akamine P.; Madhusudan; Wu J.; Xuong N. H.; Ten Eyck L. F.; Taylor S. S. (2003) Dynamic features of cAMP-dependent protein kinase revealed by apoenzyme crystal structure. J. Mol. Biol. 327, 159–171.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12614615'}}}",
"{'Citation': 'Zheng J.; Knighton D. R.; Xuong N. H.; Taylor S. S.; Sowadski J. M.; Ten Eyck L. F. (1993) Crystal structures of the myristylated catalytic subunit of cAMP-dependent protein kinase reveal open and closed conformations. Protein Sci. 2, 1559–1573.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2142252'}, {'@IdType': 'pubmed', '#text': '8251932'}]}}",
"{'Citation': 'Yang J.; Ten Eyck L. F.; Xuong N. H.; Taylor S. S. (2004) Crystal structure of a cAMP-dependent protein kinase mutant at 1.26A: New insights into the catalytic mechanism. J. Mol. Biol. 336, 473–487.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14757059'}}}",
"{'Citation': 'Narayana N.; Cox S.; Nguyen-huu X.; Ten Eyck L. F.; Taylor S. S. (1997) A binary complex of the catalytic subunit of cAMP-dependent protein kinase and adenosine further defines conformational flexibility. Structure 5, 921–935.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9261084'}}}",
"{'Citation': 'Masterson L. R.; Shi L.; Metcalfe E.; Gao J.; Taylor S. S.; Veglia G. (2011) Dynamically committed, uncommitted, and quenched states encoded in protein kinase A revealed by NMR spectroscopy. Proc. Natl. Acad. Sci. U. S. A. 108, 6969–6974.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3084134'}, {'@IdType': 'pubmed', '#text': '21471451'}]}}",
"{'Citation': 'Adams J. A. (2001) Kinetic and catalytic mechanisms of protein kinases. Chem. Rev. 101, 2271–2290.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11749373'}}}",
"{'Citation': 'Adams J. A.; Taylor S. S. (1993) Divalent metal ions influence catalysis and active-site accessibility in the cAMP-dependent protein kinase. Protein Sci. 2, 2177–2186.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2142329'}, {'@IdType': 'pubmed', '#text': '8298463'}]}}",
"{'Citation': 'Lew J.; Taylor S. S.; Adams J. A. (1997) Identification of a partially rate-determining step in the catalytic mechanism of cAMP-dependent protein kinase: A transient kinetic study using stopped-flow fluorescence spectroscopy. Biochemistry 36, 6717–6724.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9184152'}}}",
"{'Citation': 'Shaffer J.; Adams J. A. (1999) An ATP-linked structural change in protein kinase A precedes phosphoryl transfer under physiological magnesium concentrations. Biochemistry 38, 5572–5581.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10220345'}}}",
"{'Citation': 'Shaffer J.; Adams J. A. (1999) Detection of conformational changes along the kinetic pathway of protein kinase A using a catalytic trapping technique. Biochemistry 38, 12072–12079.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10508411'}}}",
"{'Citation': 'Cook P. F.; Neville M. E. Jr.; Vrana K. E.; Hartl F. T.; Roskoski R. Jr. (1982) Adenosine cyclic 3′,5′-monophosphate dependent protein kinase: Kinetic mechanism for the bovine skeletal muscle catalytic subunit. Biochemistry 21, 5794–5799.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '6295440'}}}",
"{'Citation': 'Khavrutskii I. V.; Grant B.; Taylor S. S.; McCammon J. A. (2009) A transition path ensemble study reveals a linchpin role for Mg(2+) during rate-limiting ADP release from protein kinase A. Biochemistry 48, 11532–11545.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2789581'}, {'@IdType': 'pubmed', '#text': '19886670'}]}}",
"{'Citation': 'Bossemeyer D.; Engh R. A.; Kinzel V.; Ponstingl H.; Huber R. (1993) Phosphotransferase and substrate binding mechanism of the cAMP-dependent protein kinase catalytic subunit from porcine heart as deduced from the 2.0 A structure of the complex with Mn2+ adenylyl imidodiphosphate and inhibitor peptide PKI(5–24). EMBO J. 12, 849–859.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC413283'}, {'@IdType': 'pubmed', '#text': '8384554'}]}}",
"{'Citation': 'Zheng J.; Knighton D. R.; ten Eyck L. F.; Karlsson R.; Xuong N.; Taylor S. S.; Sowadski J. M. (1993) Crystal structure of the catalytic subunit of cAMP-dependent protein kinase complexed with MgATP and peptide inhibitor. Biochemistry 32, 2154–2161.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8443157'}}}",
"{'Citation': 'Shaltiel S.; Cox S.; Taylor S. S. (1998) Conserved water molecules contribute to the extensive network of interactions at the active site of protein kinase A. Proc. Natl. Acad. Sci. U. S. A. 95, 484–491.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC18446'}, {'@IdType': 'pubmed', '#text': '9435218'}]}}",
"{'Citation': 'Kovalevsky A. Y.; Johnson H.; Hanson B. L.; Waltman M. J.; Fisher S. Z.; Taylor S.; Langan P. (2012) Low- and room-temperature X-ray structures of protein kinase A ternary complexes shed new light on its activity. Acta Crystallogr. D: Biol. Crystallogr. 68, 854–860.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3388813'}, {'@IdType': 'pubmed', '#text': '22751671'}]}}",
"{'Citation': 'Bao Z. Q.; Jacobsen D. M.; Young M. A. (2011) Briefly bound to activate: Transient binding of a second catalytic magnesium activates the structure and dynamics of CDK2 kinase for catalysis. Structure 19, 675–690.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3462661'}, {'@IdType': 'pubmed', '#text': '21565702'}]}}",
"{'Citation': 'Bastidas A. C.; Deal M. S.; Steichen J. M.; Guo Y.; Wu J.; Taylor S. S. (2013) Phosphoryl transfer by protein kinase a is captured in a crystal lattice. J. Am. Chem. Soc. 135, 4788–4798.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3663052'}, {'@IdType': 'pubmed', '#text': '23458248'}]}}",
"{'Citation': 'Jacobsen D. M.; Bao Z. Q.; O’Brien P.; Brooks C. L. 3rd; Young M. A. (2012) Price to be paid for two-metal catalysis: Magnesium ions that accelerate chemistry unavoidably limit product release from a protein kinase. J. Am. Chem. Soc. 134, 15357–15370.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3446636'}, {'@IdType': 'pubmed', '#text': '22891849'}]}}",
"{'Citation': 'Duronio R. J.; Jackson-Machelski E.; Heuckeroth R. O.; Olins P. O.; Devine C. S.; Yonemoto W.; Slice L. W.; Taylor S. S.; Gordon J. I. (1990) Protein N-myristoylation in Escherichia coli: reconstitution of a eukaryotic protein modification in bacteria. Proc. Natl. Acad. Sci. U. S. A. 87, 1506–1510.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC53504'}, {'@IdType': 'pubmed', '#text': '2406721'}]}}",
"{'Citation': 'Bastidas A. C.; Deal M. S.; Steichen J. M.; Keshwani M. M.; Guo Y.; Taylor S. S. (2012) Role of N-terminal myristylation in the structure and regulation of cAMP-dependent protein kinase. J. Mol. Biol. 422, 215–229.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3597442'}, {'@IdType': 'pubmed', '#text': '22617327'}]}}",
"{'Citation': 'Battye T. G.; Kontogiannis L.; Johnson O.; Powell H. R.; Leslie A. G. (2011) iMOSFLM: A new graphical interface for diffraction-image processing with MOSFLM. Acta Crystallogr. D: Biol. Crystallogr. 67, 271–281.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3069742'}, {'@IdType': 'pubmed', '#text': '21460445'}]}}",
"{'Citation': 'McCoy A. J.; Grosse-Kunstleve R. W.; Adams P. D.; Winn M. D.; Storoni L. C.; Read R. J. (2007) Phaser crystallographic software. J. Appl. Crystallogr. 40, 658–674.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2483472'}, {'@IdType': 'pubmed', '#text': '19461840'}]}}",
"{'Citation': '(1994) The CCP4 suite: programs for protein crystallography. Acta Crystallogr. D Biol. Crystallogr. 50, 760–763.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15299374'}}}",
"{'Citation': 'Emsley P.; Cowtan K. (2004) Coot: model-building tools for molecular graphics. Acta Crystallogr. D: Biol. Crystallogr. 60, 2126–2132.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15572765'}}}",
"{'Citation': 'Davis I. W.; Leaver-Fay A.; Chen V. B.; Block J. N.; Kapral G. J.; Wang X.; Murray L. W.; Arendall W. B. 3rd; Snoeyink J.; Richardson J. S.; et al. (2007) MolProbity: All-atom contacts and structure validation for proteins and nucleic acids. Nucleic Acids Res. 35, W375–383.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1933162'}, {'@IdType': 'pubmed', '#text': '17452350'}]}}",
"{'Citation': 'Nelson N. C.; Taylor S. S. (1981) Differential labeling and identification of the cysteine-containing tryptic peptides of catalytic subunit from porcine heart cAMP-dependent protein kinase. J. Biol. Chem. 256, 3743–3750.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '6260776'}}}",
"{'Citation': 'Batkin M.; Schvartz I.; Shaltiel S. (2000) Snapping of the carboxyl terminal tail of the catalytic subunit of PKA onto its core: Characterization of the sites by mutagenesis. Biochemistry 39, 5366–5373.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10820007'}}}",
"{'Citation': 'Yang J.; Kennedy E. J.; Wu J.; Deal M. S.; Pennypacker J.; Ghosh G.; Taylor S. S. (2009) Contribution of non-catalytic core residues to activity and regulation in protein kinase A. J. Biol. Chem. 284, 6241–6248.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2649094'}, {'@IdType': 'pubmed', '#text': '19122195'}]}}",
"{'Citation': 'Kennedy E. J.; Yang J.; Pillus L.; Taylor S. S.; Ghosh G. (2009) Identifying Critical Non-Catalytic Residues that Modulate Protein Kinase A Activity. PLoS One 4(3), e474610.1371/journal.pone.0004746.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1371/journal.pone.0004746'}, {'@IdType': 'pmc', '#text': 'PMC2650257'}, {'@IdType': 'pubmed', '#text': '19270744'}]}}",
"{'Citation': 'Hyeon C.; Jennings P. A.; Adams J. A.; Onuchic J. N. (2009) Ligand-induced global transitions in the catalytic domain of protein kinase A. Proc. Natl. Acad. Sci. U. S. A. 106, 3023–3028.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2651249'}, {'@IdType': 'pubmed', '#text': '19204278'}]}}",
"{'Citation': 'Kikani C. K.; Antonysamy S. A.; Bonanno J. B.; Romero R.; Zhang F. F.; Russell M.; Gheyi T.; Iizuka M.; Emtage S.; Sauder J. M.; et al. (2010) Structural bases of PAS domain-regulated kinase (PASK) activation in the absence of activation loop phosphorylation. J. Biol. Chem. 285, 41034–41043.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3003402'}, {'@IdType': 'pubmed', '#text': '20943661'}]}}",
"{'Citation': 'Lawrence H. R.; Martin M. P.; Luo Y.; Pireddu R.; Yang H.; Gevariya H.; Ozcan S.; Zhu J. Y.; Kendig R.; Rodriguez M.; et al. (2012) Development of o-chlorophenyl substituted pyrimidines as exceptionally potent aurora kinase inhibitors. J. Med. Chem. 55, 7392–7416.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4429609'}, {'@IdType': 'pubmed', '#text': '22803810'}]}}",
"{'Citation': 'Aoki M.; Yokota T.; Sugiura I.; Sasaki C.; Hasegawa T.; Okumura C.; Ishiguro K.; Kohno T.; Sugio S.; Matsuzaki T. (2004) Structural insight into nucleotide recognition in tau-protein kinase I/glycogen synthase kinase 3 beta. Acta Crystallogr. D: Biol. Crystallogr. 60, 439–446.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14993667'}}}",
"{'Citation': 'Fischmann T. O.; Smith C. K.; Mayhood T. W.; Myers J. E.; Reichert P.; Mannarino A.; Carr D.; Zhu H.; Wong J.; Yang R. S.; et al. (2009) Crystal structures of MEK1 binary and ternary complexes with nucleotides and inhibitors. Biochemistry 48, 2661–2674.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19161339'}}}",
"{'Citation': 'Hughes S.; Elustondo F.; Di Fonzo A.; Leroux F. G.; Wong A. C.; Snijders A. P.; Matthews S. J.; Cherepanov P. (2012) Crystal structure of human CDC7 kinase in complex with its activator DBF4. Nat. Struct. Mol. Biol. 19, 1101–1107.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23064647'}}}",
"{'Citation': 'McNamara L. K.; Watterson D. M.; Brunzelle J. S. (2009) Structural insight into nucleotide recognition by human death-associated protein kinase. Acta Crystallogr. D: Biol. Crystallogr. 65, 241–248.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2651756'}, {'@IdType': 'pubmed', '#text': '19237746'}]}}",
"{'Citation': 'Ko T. P.; Jeng W. Y.; Liu C. I.; Lai M. D.; Wu C. L.; Chang W. J.; Shr H. L.; Lu T. J.; Wang A. H. (2010) Structures of human MST3 kinase in complex with adenine, ADP and Mn2+. Acta Crystallogr. D: Biol. Crystallogr. 66, 145–154.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20124694'}}}",
"{'Citation': 'Singh P.; Wang B.; Maeda T.; Palczewski K.; Tesmer J. J. (2008) Structures of rhodopsin kinase in different ligand states reveal key elements involved in G protein-coupled receptor kinase activation. J. Biol. Chem. 283, 14053–14062.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2376226'}, {'@IdType': 'pubmed', '#text': '18339619'}]}}",
"{'Citation': 'Richards M. W.; O’Regan L.; Mas-Droux C.; Blot J. M.; Cheung J.; Hoelder S.; Fry A. M.; Bayliss R. (2009) An autoinhibitory tyrosine motif in the cell-cycle-regulated Nek7 kinase is released through binding of Nek9. Mol. Cell 36, 560–570.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2807034'}, {'@IdType': 'pubmed', '#text': '19941817'}]}}",
"{'Citation': 'Westwood I.; Cheary D. M.; Baxter J. E.; Richards M. W.; van Montfort R. L.; Fry A. M.; Bayliss R. (2009) Insights into the conformational variability and regulation of human Nek2 kinase. J. Mol. Biol. 386, 476–485.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2741569'}, {'@IdType': 'pubmed', '#text': '19124027'}]}}"
] | Plast Reconstr Surg Glob Open. 2015 Jan 8; 2(12):e273 | NO-CC CODE |
|
CT scans – consolidations in the basal lobes of both lungs in the pulmonary and mediastinal window. | poljradiol-80-18-g004 | 7 | 27a9587a87ec58100309f8c7d04eee9a3b46caf374e80999ce2ef391439e0aa0 | poljradiol-80-18-g004.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
720
] | [{'image_id': 'poljradiol-80-18-g001', 'image_file_name': 'poljradiol-80-18-g001.jpg', 'image_path': '../data/media_files/PMC4293316/poljradiol-80-18-g001.jpg', 'caption': 'Initial X-ray reveals heterogeneous congestion of both lungs, mostly in the lower right lobe.', 'hash': '5e592dca283a2d8f50ff81733fbda33a01bb19a4dc273b119f3e1c75941055aa'}, {'image_id': 'poljradiol-80-18-g005', 'image_file_name': 'poljradiol-80-18-g005.jpg', 'image_path': '../data/media_files/PMC4293316/poljradiol-80-18-g005.jpg', 'caption': 'Control X-ray shows partial regression of inflammatory lesions in both lungs.', 'hash': '51d487a9665daa0e389b44aa6d45771192ec19bc70e267055ef761944fffacf1'}, {'image_id': 'poljradiol-80-18-g002', 'image_file_name': 'poljradiol-80-18-g002.jpg', 'image_path': '../data/media_files/PMC4293316/poljradiol-80-18-g002.jpg', 'caption': 'Control X-ray: multifocal inflammatory and atelectatic areas are seen in the right lobe which was defined as progression of pathological changes. Similar changes are also present in the left lower lobe.', 'hash': '1ae97cdaf8d9b6f3a50d4075fe8d35e0540d3d60214836f4197acd837edd7259'}, {'image_id': 'poljradiol-80-18-g003', 'image_file_name': 'poljradiol-80-18-g003.jpg', 'image_path': '../data/media_files/PMC4293316/poljradiol-80-18-g003.jpg', 'caption': 'CT. Initial examination shows massive hypodense, irregular area of lung tissue consolidation in the basal lobes of the right and left lung. After 1 month a control scan revealed almost complete regression of radiological findings in the lungs. The last scan after 3 months showed only pleural parenchymal scarring and no other findings.', 'hash': '22dc15c25def0ea47945df0f48073f8c13f66dcf8098804ae882229fae7a169a'}, {'image_id': 'poljradiol-80-18-g004', 'image_file_name': 'poljradiol-80-18-g004.jpg', 'image_path': '../data/media_files/PMC4293316/poljradiol-80-18-g004.jpg', 'caption': 'CT scans – consolidations in the basal lobes of both lungs in the pulmonary and mediastinal window.', 'hash': '27a9587a87ec58100309f8c7d04eee9a3b46caf374e80999ce2ef391439e0aa0'}] | {'poljradiol-80-18-g001': ['A 16-year-old female patient with a history of asthma was admitted to hospital with a fever of 40 degrees Celsius, persistent cough and a chest pain. The examination revealed wheezes and coarse rales over the lungs – mostly on the right side. Lab tests were performed: white blood cell count 27.5×109/L, C-reactive protein 12.2 mg/dL and erythrocyte sedimentation rate 34 mm/h. Chest radiograph showed heterogeneous congestion of the lungs (<xref ref-type="fig" rid="poljradiol-80-18-g001">Figure 1</xref>). Treatment with antibiotics, analgesics, and hydration was instituted but the condition of the patient over the following 7 days worsened and that was a reason for her transfer to the Pediatric Clinic of Cardiology and Allergology for further treatment. In a carefully-taken history, the patient admitted that she had been a fire-eater for the last 3 years and during the last performance aspiration of large amounts of petroleum occurred. An immediately performed chest radiograph showed multifocal inflammatory lesions in both lungs, and atelectatic areas in the right one which was defined as progression of pathological changes compared to the previous examination (). Treatment with antibiotics, analgesics, and hydration was instituted but the condition of the patient over the following 7 days worsened and that was a reason for her transfer to the Pediatric Clinic of Cardiology and Allergology for further treatment. In a carefully-taken history, the patient admitted that she had been a fire-eater for the last 3 years and during the last performance aspiration of large amounts of petroleum occurred. An immediately performed chest radiograph showed multifocal inflammatory lesions in both lungs, and atelectatic areas in the right one which was defined as progression of pathological changes compared to the previous examination (<xref ref-type="fig" rid="poljradiol-80-18-g002">Figure 2</xref>). After 2 days HRCT of the chest was performed. It showed a massive hypodense, irregular area of lung tissue consolidation in the basal lobes of the right lung (). After 2 days HRCT of the chest was performed. It showed a massive hypodense, irregular area of lung tissue consolidation in the basal lobes of the right lung (<xref ref-type="fig" rid="poljradiol-80-18-g003">Figures 3</xref> and and <xref ref-type="fig" rid="poljradiol-80-18-g004">4</xref>). Within that lesion small amounts of air were visible. Smaller lesions of the same kind were located in the basal segments of the left lung. Moreover, a small amount of pleural effusion and a small cavity between segment 4 and 5 of the left lung were found. Those radiological findings were also reported on by other authors and are considered to be typical [). Within that lesion small amounts of air were visible. Smaller lesions of the same kind were located in the basal segments of the left lung. Moreover, a small amount of pleural effusion and a small cavity between segment 4 and 5 of the left lung were found. Those radiological findings were also reported on by other authors and are considered to be typical [7–9]. The same day bronchoscopy was performed. It showed massive inflammation of airway mucosa and presence of lipid-laden macrophages in bronchoalveolar lavage fluid. During the procedure purulent secretion from segmental bronchi was siphoned off. Because of further aggravation of patient’s condition (severe dyspnea and respiratory failure) she was transferred to Intensive Care Unit. Surgical intervention was taken into consideration due to the risk of lung abscesses, but on the basis of radiological examinations, a decision on conservatory treatment was undertaken.'], 'poljradiol-80-18-g005': ['The next chest radiograph showed partial regression of inflammatory lesions in both lungs (<xref ref-type="fig" rid="poljradiol-80-18-g005">Figure 5</xref>). Also the general condition of the patient started to improve. A control chest HRCT revealed almost complete regression of radiological findings (). Also the general condition of the patient started to improve. A control chest HRCT revealed almost complete regression of radiological findings (<xref ref-type="fig" rid="poljradiol-80-18-g003">Figure 3</xref>). Only residual area of lung tissue consolidation in the 6). Only residual area of lung tissue consolidation in the 6th segment of the right lung and bilateral pleural parenchymal scarring in basal segments were displayed. The patient was discharged and a follow-up HRCT in 3 months was recommended. It showed only pleural parenchymal scarring and no other findings (<xref ref-type="fig" rid="poljradiol-80-18-g003">Figure 3</xref>).).']} | Case Report of Fire Eater’s Pneumonia in Adolescent Female Patient – Evolution of Radiologic Findings | [
"Pediatrics",
"Pneumonia, Lipid",
"Tomography, Spiral Computed"
] | Pol J Radiol | 1420876800 | None | null | other | PMC4293316 | null | null | [
""
] | Pol J Radiol. 2015 Jan 10; 80:18-21 | NO-CC CODE |
|
CT Thorax (A – Axial, B – Coronal) showing mild main pulmonary artery dilatation, normal intrapulmonary vessels with no peripheral dilatation. | amjcaserep-18-1-g001 | 7 | 2be3fc2561f0a67802f67c3725f24e8e76557287ac1821d9db3b2d36c74c0c51 | amjcaserep-18-1-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
792,
360
] | [{'image_id': 'amjcaserep-18-1-g002', 'image_file_name': 'amjcaserep-18-1-g002.jpg', 'image_path': '../data/media_files/PMC5221740/amjcaserep-18-1-g002.jpg', 'caption': 'Pathological changes in the lung from VATS biopsy. The branches of the pulmonary arteries are dilated (stars, A), or show medial hypertrophy (arrow, B). Plexiform lesions are also present (arrow heads, C) (PA – pulmonary artery; br – bronchiole) (hematoxylin and eosin stain, magnification ×40 (A), ×100 (B), ×200 (C), scale bar 100 µm).', 'hash': '950c2f56e2ea7b6aea0171f1388432cf7d4926ce7146f21eb4864f24ad13a6fc'}, {'image_id': 'amjcaserep-18-1-g003', 'image_file_name': 'amjcaserep-18-1-g003.jpg', 'image_path': '../data/media_files/PMC5221740/amjcaserep-18-1-g003.jpg', 'caption': 'Histology of the explanted liver show cirrhosis (A) and steatosis (B) (hematoxylin and eosin stain, magnification ×20 (A), ×100 (B), scale bar 1000 µm (A) and 100 µm (B)).', 'hash': 'c8aef287091aff95e97222725c974dc865d0d826a99a7d565a8df9085146dc70'}, {'image_id': 'amjcaserep-18-1-g001', 'image_file_name': 'amjcaserep-18-1-g001.jpg', 'image_path': '../data/media_files/PMC5221740/amjcaserep-18-1-g001.jpg', 'caption': 'CT Thorax (A – Axial, B – Coronal) showing mild main pulmonary artery dilatation, normal intrapulmonary vessels with no peripheral dilatation.', 'hash': '2be3fc2561f0a67802f67c3725f24e8e76557287ac1821d9db3b2d36c74c0c51'}] | {'amjcaserep-18-1-g001': ['In the absence of any detectable pulmonary or cardiac etiology, video-assisted thoracoscopic (VATS) lung biopsy was planned to rule out other primary pulmonary pathology. He tolerated this procedure well and significant macroscopic venous dilatation was noted at surgery. CTPA had been repeated as a part of preoperative investigations (<xref ref-type="fig" rid="amjcaserep-18-1-g001">Figure 1</xref>), this time revealing mild main pulmonary artery dilatation and normal intrapulmonary vessels with no peripheral dilatation, but there was incidental detection of features suggestive of liver cirrhosis on upper abdominal cuts.), this time revealing mild main pulmonary artery dilatation and normal intrapulmonary vessels with no peripheral dilatation, but there was incidental detection of features suggestive of liver cirrhosis on upper abdominal cuts.'], 'amjcaserep-18-1-g002': ['His liver function tests (LFTs) were normal (Table 1). Coagulation profile showed thrombocytopenia with a count of 60 000 per microliter. Four-phase CT liver revealed cirrhosis with portal hypertension and splenomegaly. Hepatic venous pressure gradient measurement showed HVPG of 10 mmHg, further confirming portal hypertension. Upper gastrointestinal endoscopy revealed gastric varices. HPS was suspected at this point and confirmed through a repeat bubble test, which was positive for intrapulmonary shunt (IPS). VATS lung biopsy showed histological features compatible with HPS and pulmonary artery hypertension with extensive vascular remodeling (<xref ref-type="fig" rid="amjcaserep-18-1-g002">Figure 2</xref>). His oxygenation was gradually deteriorating, with cyanosis and room air PO2 of 53.2 mm Hg. He was listed for orthotopic liver transplantation, with severe hepatopulmonary syndrome and mild portopulmonary hypertension (POPH) from NASH-related cirrhosis as the indication, confirmed on pathological examination of the explanted liver (). His oxygenation was gradually deteriorating, with cyanosis and room air PO2 of 53.2 mm Hg. He was listed for orthotopic liver transplantation, with severe hepatopulmonary syndrome and mild portopulmonary hypertension (POPH) from NASH-related cirrhosis as the indication, confirmed on pathological examination of the explanted liver (<xref ref-type="fig" rid="amjcaserep-18-1-g003">Figure 3</xref>). His model for end-stage liver disease (MELD) score was 7 at the time of listing and he remained on continuous home oxygen therapy at 2 l/min while waiting for transplantation. He was successfully transplanted 1 year after listing. His intraoperative and postoperative periods were uneventful and he was discharged home after 14 days. At 12-month follow-up, our patient remains asymptomatic with normal resting oxygen saturation and requiring 2 l/min of supplemental oxygen for mobilization.). His model for end-stage liver disease (MELD) score was 7 at the time of listing and he remained on continuous home oxygen therapy at 2 l/min while waiting for transplantation. He was successfully transplanted 1 year after listing. His intraoperative and postoperative periods were uneventful and he was discharged home after 14 days. At 12-month follow-up, our patient remains asymptomatic with normal resting oxygen saturation and requiring 2 l/min of supplemental oxygen for mobilization.']} | Prolonged Unexplained Hypoxemia as Initial Presentation of Cirrhosis: A Case Report | [
"Anoxia",
"Hepatopulmonary Syndrome",
"Liver Transplantation"
] | Am J Case Rep | 1483344000 | Bacterial biofilms are a major cause of chronic infections and biofouling; however, effective removal of established biofilms remains challenging. Here we report a new strategy for biofilm control using biocompatible shape memory polymers with defined surface topography. These surfaces can both prevent bacterial adhesion and remove established biofilms upon rapid shape change with moderate increase of temperature, thereby offering more prolonged antifouling properties. We demonstrate that this strategy can achieve a total reduction of Pseudomonas aeruginosa biofilms by 99.9% compared to the static flat control. It was also found effective against biofilms of Staphylococcus aureus and an uropathogenic strain of Escherichia coli. | [
"Bacterial Adhesion",
"Biofilms",
"Biofouling",
"Pseudomonas aeruginosa",
"Staphylococcus aureus"
] | other | PMC5221740 | null | 29 | [
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] | Am J Case Rep. 2017 Jan 2; 18:1-6 | NO-CC CODE |
|
A repeat CT scan of chest showing complete resolution of infiltrates. | amjcaserep-18-67-g003 | 7 | b20e58b0d745562452edad24251f532874fb6e3afee0482e8e8632cdaabe9a65 | amjcaserep-18-67-g003.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
780,
348
] | [{'image_id': 'amjcaserep-18-67-g001', 'image_file_name': 'amjcaserep-18-67-g001.jpg', 'image_path': '../data/media_files/PMC5267618/amjcaserep-18-67-g001.jpg', 'caption': 'Chest CT scan showing a right lower lobe cavitary mass/consolidation with minimal right pleural effusion (black arrow).', 'hash': '830b44f1ecb74e456f077d6eae88eb7b1bd00e2499219c2307ef1f028bf649cb'}, {'image_id': 'amjcaserep-18-67-g003', 'image_file_name': 'amjcaserep-18-67-g003.jpg', 'image_path': '../data/media_files/PMC5267618/amjcaserep-18-67-g003.jpg', 'caption': 'A repeat CT scan of chest showing complete resolution of infiltrates.', 'hash': 'b20e58b0d745562452edad24251f532874fb6e3afee0482e8e8632cdaabe9a65'}, {'image_id': 'amjcaserep-18-67-g002', 'image_file_name': 'amjcaserep-18-67-g002.jpg', 'image_path': '../data/media_files/PMC5267618/amjcaserep-18-67-g002.jpg', 'caption': 'Chest CT scan demonstrating increased mass-like consolidative opacity (black arrow).', 'hash': '4d4ee365d7f9fa80ba5fd72a088a3bf8ead9aa0cb5681a39bac7e5e4289cecef'}] | {'amjcaserep-18-67-g001': ['His physical examination showed an ill-looking man with mild respiratory distress. His vital signs were heart rate 104/min, blood pressure 145/91 mm Hg, respiratory rate 18 breaths/min, oxygen saturation 91% on room air, and temperature 102°F. He had a non-productive cough, and auscultation of the chest revealed reduced breath sounds in the right lung base with right basal crackles. There was no clubbing. His cardiac examination revealed tachycardia but no murmurs, rubs, or gallop. There was no hepatosplenomegaly, and the neurological exam was normal. Laboratory studies showed no leukocytosis, mild anemia of chronic diseases, and low albumin levels. Urinalysis was unremarkable. Chest radiography showed a 4.5 cm rounded mass-like opacity in the right hilar area. Therefore, a computed tomography (CT) scan of the chest was obtained, which revealed a right lower lobe cavitary mass/consolidation measuring 7.8×6.5 cm, with minimal right pleural effusion (<xref ref-type="fig" rid="amjcaserep-18-67-g001">Figure 1</xref>).).'], 'amjcaserep-18-67-g002': ['His initial intravenous antibiotic regimen was changed to linezolid 600 mg every 12 hours, levofloxacin 750 mg daily, and azithromycin 500 mg daily. His condition improved significantly, he became afebrile, cough and chest pains resolved, and he was discharged in stable condition on oral azithromycin 500 mg daily and levofloxacin 750 mg daily for 8 weeks. The patient was also referred to the outpatient HIV program at the hospital for follow-up, where his HAART regimen was changed to ritonavir 100 mg daily, darunavir 800 mg daily, and emtricitabine-tenofovir 200–300 mg, as genotypic resistance indicated failure of rilpivirine. Three weeks after the switch to the new HAART and while on week 4 of levofloxacin and azithromycin, the patient started having right-sided chest pain and cough with low-grade temperature. The repeat CD4 count was 62 cells/μm and a viral load of 86 copies/mL. A repeat (2nd) CT scan of the chest demonstrated increased mass-like consolidative opacity measuring 9.7×7.9 cm. The cavitation itself was roughly stable at 2 cm (<xref ref-type="fig" rid="amjcaserep-18-67-g002">Figure 2</xref>).).'], 'amjcaserep-18-67-g003': ['Oral linezolid 600 mg twice a day was added to azithromycin and levofloxacin. All three antibiotics were continued for 2 weeks, and then azithromycin and levofloxacin were discontinued. Linezolid was continued for a total of 4 weeks to complete a total course of 8 weeks of therapy. The CT scan findings were concerning; however, given the patient’s improved virological and immunological status and negative workup for other potential differential diagnoses, he was treated symptomatically with low-dose non-steroidal anti-inflammatory agents and close biweekly clinic follow-ups. His symptoms continued to improve, and he gained close to 30 lbs in the following 4 months, with HIV RNA becoming fewer than 20 copies and CD4 count of 236 cells/mL. He had an episode of herpes zoster involving right 10–11th thoracic dermatomal distribution, which was treated with oral valacyclovir 1 g three times a day for 10 days. No steroids were used during this episode. The patient has been free of any other OI or R. equi relapses since discharge from hospital in the past 8 months, and a repeat (3rd) CT of chest (<xref ref-type="fig" rid="amjcaserep-18-67-g003">Figure 3</xref>) showed almost complete resolution of infiltrates.) showed almost complete resolution of infiltrates.']} | Rhodoccocus Equi Pneumonia and Paradoxical Immune Reconstitution Inflammatory Syndrome in a Patient with Acquired Immune Deficiency Syndrome (AIDS) | [
"Acquired Immunodeficiency Syndrome",
"Immune Reconstitution Inflammatory Syndrome",
"{'italic': 'Rhodoccocus equi'}"
] | Am J Case Rep | 1484812800 | BACKGROUND Pulmonary infections are a major cause of mortality and morbidity in patients infected with human immunodeficiency virus (HIV) and can progress rapidly to respiratory failure and death without appropriate therapy. Herein, we present a rare case of an advanced HIV infection and Rhodoccocus equi (R. equi) pneumonia in a young male who had severe paradoxical immune reconstitution inflammatory syndrome (IRIS). CASE REPORT A 47-year-old nonsmoking Hispanic man with advanced HIV infection presented with severe acute necrotizing pneumonia secondary to R. equi. Although his initial response to antimicrobial therapy was optimal, he became symptomatic again in spite of continuation of antibiotics as he developed severe paradoxical IRIS 3 weeks after starting a new highly active anti-retroviral therapy (HAART). CONCLUSIONS The diagnosis of IRIS remains challenging because of the wide variations in the clinical presentation and etiologies. In spite of its rarity as an opportunistic pathogen, we recommend that R. equi, an intracellular pathogen, be included in the differential list of pathogens associated with IRIS. | [
"Acquired Immunodeficiency Syndrome",
"Biopsy",
"HIV",
"Humans",
"Immune Reconstitution Inflammatory Syndrome",
"Male",
"Middle Aged",
"Pneumonia",
"Tomography, X-Ray Computed"
] | other | PMC5267618 | null | 20 | [
"{'Citation': 'Centers for Disease Control and Prevention [Internet] HIV in the United States: At A Glance. HIV/AIDS Statistics Center. [Updated: 10-20-2016] Available from: URL: http://www.cdc.gov/hiv/statistics/overview/ataglance.html.'}",
"{'Citation': 'Huang L, Crothers K. HIV-associated opportunistic pneumonias. Respirology. 2009;14(4):474–85.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2835537'}, {'@IdType': 'pubmed', '#text': '19645867'}]}}",
"{'Citation': 'd’Arminio Monforte A, Sabin CA, Phillips A, et al. The changing incidence of AIDS events in patients receiving highly active antiretroviral therapy. Arch Intern Med. 2005;165(4):416–23.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15738371'}}}",
"{'Citation': 'Zheng Y, Zhou H, He Y, et al. The immune pathogenesis of immune reconstitution inflammatory syndrome associated with highly active antiretroviral therapy in AIDS. AIDS Res Hum Retroviruses. 2014;30(12):1197–202.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4250954'}, {'@IdType': 'pubmed', '#text': '25131160'}]}}",
"{'Citation': 'Lattur M, Marco D, García Gasalla M, et al. [Rhodoccocus equi pulmonary infection in a HIV-infected patient and radiological worsening following treatment: Case report] An Med Interna. 2008;25:370–71. [in Spanish]', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19296001'}}}",
"{'Citation': 'Ferretti F, Boschini A, Iabichino C, et al. Disseminated Rhodoccocus equi infection in HIV infection despite highly active antiretroviral therapy. BMC Infect Dis. 2011;11:343.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3295727'}, {'@IdType': 'pubmed', '#text': '22168333'}]}}",
"{'Citation': 'Giguère S, Cohen ND, Keith Chaffin M, et al. Rhodoccocus equi: Clinical manifestations, virulence, and immunity. J Vet Intern Med. 2011;25:1221–30.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22092609'}}}",
"{'Citation': 'Weinstock DM, Brown AE. Rhodoccocus equi: An emerging pathogen. Clin Infect Dis. 2002;34(10):1379–85.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11981734'}}}",
"{'Citation': 'Le T, Cash-Goldwasser S, Tho PV, et al. Diagnosing Rhodoccocus equi infections in a setting where tuberculosis is highly endemic: A double challenge. J Clin Microbiol. 2015;53(4):1431–33.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4365230'}, {'@IdType': 'pubmed', '#text': '25631800'}]}}",
"{'Citation': 'Muller M, Wandel S, Colebunders R, et al. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: A systematic review and meta-analysis. Lancet Infect Dis. 2010;10:251–61.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4183458'}, {'@IdType': 'pubmed', '#text': '20334848'}]}}",
"{'Citation': 'Burton AJ, Giguère S, Berghaus LJ, Hondalus MK. Activity of clarithromycin or rifampin alone or in combination against experimental Rhodoccocus equi infection in mice. Antimicrob Agents Chemother. 2015;59:3633–36.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4432177'}, {'@IdType': 'pubmed', '#text': '25824218'}]}}",
"{'Citation': 'Muñoz P, Palomo J, Guinea J, et al. Relapsing Rhodoccocus equi infection in a heart transplant recipient successfully treated with long-term linezolid. Diagn Microbiol Infect Dis. 2008;60(2):197–99.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17949934'}}}",
"{'Citation': 'Bowersock TL, Salmon SA, Portis ES, et al. MICs of oxazolidinones for Rhodoccocus equi strains isolated from humans and animals. Antimicrob Agents Chemother. 2000;44(5):1367–69.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC89874'}, {'@IdType': 'pubmed', '#text': '10770781'}]}}",
"{'Citation': 'Yamshchikov AV, Schuetz A, Lyon GM. Rhodoccocus equi infection. Lancet Infect Dis. 2010;10(5):350–59.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20417417'}}}",
"{'Citation': 'Toyooka K, Takai S, Kirikae T. Rhodococus equi can survive a phagolysosomal environment in macrophages by suppressing acidification of the phagolysosome. J Med Microbiol. 2005;54(Pt 11):1007–15.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16192430'}}}",
"{'Citation': 'Delia S, Mastroianni CM, Lichtner M, et al. Defective production of interferon-gamma and tumour necrosis factor-alpha by AIDS mononuclear cells after in vitro exposure to Rhodoccocus equi. Mediators Inflamm. 1995;4(4):306–9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2365645'}, {'@IdType': 'pubmed', '#text': '18475656'}]}}",
"{'Citation': 'Achenbach CJ, Harrington RD, Dhanireddy S, et al. Paradoxical immune reconstitution inflammatory syndrome in HIV-infected patients treated with combination antiretroviral therapy after AIDS-defining opportunistic infection. Clin Infect Dis. 2012;54(3):424–33.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3258272'}, {'@IdType': 'pubmed', '#text': '22095568'}]}}",
"{'Citation': 'Huis in’t Veld D, Sun HY, Hung CC, Colebunders R. The immune reconstitution inflammatory syndrome related to HIV Co-Infections: A review. Eur J Clin Microbiol Infect Dis. 2012;31:919–27.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21964588'}}}",
"{'Citation': 'Grant P, Komarow L, Sereti I, et al. Risk factor analyses for immune reconstitution inflammatory syndrome and mortality during a randomized trial of early versus deferred ART in the setting of acute opportunistic infections: ACTG A5164. Sixteenth Conference on Retroviruses and Opportunistic Infections; February 8–11 2009; Montreal, Canada.'}",
"{'Citation': 'Shelburne SA, 3rd, Darcourt J, White AC, Jr, et al. The role of immune reconstitution inflammatory syndrome in AIDS-related Cryptococcus neofor-mans disease in the era of highly active antiretroviral therapy. Clin Infect Dis. 2005;40(7):1049–52.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15825000'}}}"
] | Am J Case Rep. 2017 Jan 19; 18:67-71 | NO-CC CODE |
|
Chest CT scan demonstrating increased mass-like consolidative opacity (black arrow). | amjcaserep-18-67-g002 | 7 | 4d4ee365d7f9fa80ba5fd72a088a3bf8ead9aa0cb5681a39bac7e5e4289cecef | amjcaserep-18-67-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
780,
324
] | [{'image_id': 'amjcaserep-18-67-g001', 'image_file_name': 'amjcaserep-18-67-g001.jpg', 'image_path': '../data/media_files/PMC5267618/amjcaserep-18-67-g001.jpg', 'caption': 'Chest CT scan showing a right lower lobe cavitary mass/consolidation with minimal right pleural effusion (black arrow).', 'hash': '830b44f1ecb74e456f077d6eae88eb7b1bd00e2499219c2307ef1f028bf649cb'}, {'image_id': 'amjcaserep-18-67-g003', 'image_file_name': 'amjcaserep-18-67-g003.jpg', 'image_path': '../data/media_files/PMC5267618/amjcaserep-18-67-g003.jpg', 'caption': 'A repeat CT scan of chest showing complete resolution of infiltrates.', 'hash': 'b20e58b0d745562452edad24251f532874fb6e3afee0482e8e8632cdaabe9a65'}, {'image_id': 'amjcaserep-18-67-g002', 'image_file_name': 'amjcaserep-18-67-g002.jpg', 'image_path': '../data/media_files/PMC5267618/amjcaserep-18-67-g002.jpg', 'caption': 'Chest CT scan demonstrating increased mass-like consolidative opacity (black arrow).', 'hash': '4d4ee365d7f9fa80ba5fd72a088a3bf8ead9aa0cb5681a39bac7e5e4289cecef'}] | {'amjcaserep-18-67-g001': ['His physical examination showed an ill-looking man with mild respiratory distress. His vital signs were heart rate 104/min, blood pressure 145/91 mm Hg, respiratory rate 18 breaths/min, oxygen saturation 91% on room air, and temperature 102°F. He had a non-productive cough, and auscultation of the chest revealed reduced breath sounds in the right lung base with right basal crackles. There was no clubbing. His cardiac examination revealed tachycardia but no murmurs, rubs, or gallop. There was no hepatosplenomegaly, and the neurological exam was normal. Laboratory studies showed no leukocytosis, mild anemia of chronic diseases, and low albumin levels. Urinalysis was unremarkable. Chest radiography showed a 4.5 cm rounded mass-like opacity in the right hilar area. Therefore, a computed tomography (CT) scan of the chest was obtained, which revealed a right lower lobe cavitary mass/consolidation measuring 7.8×6.5 cm, with minimal right pleural effusion (<xref ref-type="fig" rid="amjcaserep-18-67-g001">Figure 1</xref>).).'], 'amjcaserep-18-67-g002': ['His initial intravenous antibiotic regimen was changed to linezolid 600 mg every 12 hours, levofloxacin 750 mg daily, and azithromycin 500 mg daily. His condition improved significantly, he became afebrile, cough and chest pains resolved, and he was discharged in stable condition on oral azithromycin 500 mg daily and levofloxacin 750 mg daily for 8 weeks. The patient was also referred to the outpatient HIV program at the hospital for follow-up, where his HAART regimen was changed to ritonavir 100 mg daily, darunavir 800 mg daily, and emtricitabine-tenofovir 200–300 mg, as genotypic resistance indicated failure of rilpivirine. Three weeks after the switch to the new HAART and while on week 4 of levofloxacin and azithromycin, the patient started having right-sided chest pain and cough with low-grade temperature. The repeat CD4 count was 62 cells/μm and a viral load of 86 copies/mL. A repeat (2nd) CT scan of the chest demonstrated increased mass-like consolidative opacity measuring 9.7×7.9 cm. The cavitation itself was roughly stable at 2 cm (<xref ref-type="fig" rid="amjcaserep-18-67-g002">Figure 2</xref>).).'], 'amjcaserep-18-67-g003': ['Oral linezolid 600 mg twice a day was added to azithromycin and levofloxacin. All three antibiotics were continued for 2 weeks, and then azithromycin and levofloxacin were discontinued. Linezolid was continued for a total of 4 weeks to complete a total course of 8 weeks of therapy. The CT scan findings were concerning; however, given the patient’s improved virological and immunological status and negative workup for other potential differential diagnoses, he was treated symptomatically with low-dose non-steroidal anti-inflammatory agents and close biweekly clinic follow-ups. His symptoms continued to improve, and he gained close to 30 lbs in the following 4 months, with HIV RNA becoming fewer than 20 copies and CD4 count of 236 cells/mL. He had an episode of herpes zoster involving right 10–11th thoracic dermatomal distribution, which was treated with oral valacyclovir 1 g three times a day for 10 days. No steroids were used during this episode. The patient has been free of any other OI or R. equi relapses since discharge from hospital in the past 8 months, and a repeat (3rd) CT of chest (<xref ref-type="fig" rid="amjcaserep-18-67-g003">Figure 3</xref>) showed almost complete resolution of infiltrates.) showed almost complete resolution of infiltrates.']} | Rhodoccocus Equi Pneumonia and Paradoxical Immune Reconstitution Inflammatory Syndrome in a Patient with Acquired Immune Deficiency Syndrome (AIDS) | [
"Acquired Immunodeficiency Syndrome",
"Immune Reconstitution Inflammatory Syndrome",
"{'italic': 'Rhodoccocus equi'}"
] | Am J Case Rep | 1484812800 | BACKGROUND Pulmonary infections are a major cause of mortality and morbidity in patients infected with human immunodeficiency virus (HIV) and can progress rapidly to respiratory failure and death without appropriate therapy. Herein, we present a rare case of an advanced HIV infection and Rhodoccocus equi (R. equi) pneumonia in a young male who had severe paradoxical immune reconstitution inflammatory syndrome (IRIS). CASE REPORT A 47-year-old nonsmoking Hispanic man with advanced HIV infection presented with severe acute necrotizing pneumonia secondary to R. equi. Although his initial response to antimicrobial therapy was optimal, he became symptomatic again in spite of continuation of antibiotics as he developed severe paradoxical IRIS 3 weeks after starting a new highly active anti-retroviral therapy (HAART). CONCLUSIONS The diagnosis of IRIS remains challenging because of the wide variations in the clinical presentation and etiologies. In spite of its rarity as an opportunistic pathogen, we recommend that R. equi, an intracellular pathogen, be included in the differential list of pathogens associated with IRIS. | [
"Acquired Immunodeficiency Syndrome",
"Biopsy",
"HIV",
"Humans",
"Immune Reconstitution Inflammatory Syndrome",
"Male",
"Middle Aged",
"Pneumonia",
"Tomography, X-Ray Computed"
] | other | PMC5267618 | null | 20 | [
"{'Citation': 'Centers for Disease Control and Prevention [Internet] HIV in the United States: At A Glance. HIV/AIDS Statistics Center. [Updated: 10-20-2016] Available from: URL: http://www.cdc.gov/hiv/statistics/overview/ataglance.html.'}",
"{'Citation': 'Huang L, Crothers K. HIV-associated opportunistic pneumonias. Respirology. 2009;14(4):474–85.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2835537'}, {'@IdType': 'pubmed', '#text': '19645867'}]}}",
"{'Citation': 'd’Arminio Monforte A, Sabin CA, Phillips A, et al. The changing incidence of AIDS events in patients receiving highly active antiretroviral therapy. Arch Intern Med. 2005;165(4):416–23.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15738371'}}}",
"{'Citation': 'Zheng Y, Zhou H, He Y, et al. The immune pathogenesis of immune reconstitution inflammatory syndrome associated with highly active antiretroviral therapy in AIDS. AIDS Res Hum Retroviruses. 2014;30(12):1197–202.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4250954'}, {'@IdType': 'pubmed', '#text': '25131160'}]}}",
"{'Citation': 'Lattur M, Marco D, García Gasalla M, et al. [Rhodoccocus equi pulmonary infection in a HIV-infected patient and radiological worsening following treatment: Case report] An Med Interna. 2008;25:370–71. [in Spanish]', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19296001'}}}",
"{'Citation': 'Ferretti F, Boschini A, Iabichino C, et al. Disseminated Rhodoccocus equi infection in HIV infection despite highly active antiretroviral therapy. BMC Infect Dis. 2011;11:343.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3295727'}, {'@IdType': 'pubmed', '#text': '22168333'}]}}",
"{'Citation': 'Giguère S, Cohen ND, Keith Chaffin M, et al. Rhodoccocus equi: Clinical manifestations, virulence, and immunity. J Vet Intern Med. 2011;25:1221–30.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22092609'}}}",
"{'Citation': 'Weinstock DM, Brown AE. Rhodoccocus equi: An emerging pathogen. Clin Infect Dis. 2002;34(10):1379–85.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11981734'}}}",
"{'Citation': 'Le T, Cash-Goldwasser S, Tho PV, et al. Diagnosing Rhodoccocus equi infections in a setting where tuberculosis is highly endemic: A double challenge. J Clin Microbiol. 2015;53(4):1431–33.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4365230'}, {'@IdType': 'pubmed', '#text': '25631800'}]}}",
"{'Citation': 'Muller M, Wandel S, Colebunders R, et al. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: A systematic review and meta-analysis. Lancet Infect Dis. 2010;10:251–61.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4183458'}, {'@IdType': 'pubmed', '#text': '20334848'}]}}",
"{'Citation': 'Burton AJ, Giguère S, Berghaus LJ, Hondalus MK. Activity of clarithromycin or rifampin alone or in combination against experimental Rhodoccocus equi infection in mice. Antimicrob Agents Chemother. 2015;59:3633–36.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4432177'}, {'@IdType': 'pubmed', '#text': '25824218'}]}}",
"{'Citation': 'Muñoz P, Palomo J, Guinea J, et al. Relapsing Rhodoccocus equi infection in a heart transplant recipient successfully treated with long-term linezolid. Diagn Microbiol Infect Dis. 2008;60(2):197–99.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17949934'}}}",
"{'Citation': 'Bowersock TL, Salmon SA, Portis ES, et al. MICs of oxazolidinones for Rhodoccocus equi strains isolated from humans and animals. Antimicrob Agents Chemother. 2000;44(5):1367–69.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC89874'}, {'@IdType': 'pubmed', '#text': '10770781'}]}}",
"{'Citation': 'Yamshchikov AV, Schuetz A, Lyon GM. Rhodoccocus equi infection. Lancet Infect Dis. 2010;10(5):350–59.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20417417'}}}",
"{'Citation': 'Toyooka K, Takai S, Kirikae T. Rhodococus equi can survive a phagolysosomal environment in macrophages by suppressing acidification of the phagolysosome. J Med Microbiol. 2005;54(Pt 11):1007–15.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16192430'}}}",
"{'Citation': 'Delia S, Mastroianni CM, Lichtner M, et al. Defective production of interferon-gamma and tumour necrosis factor-alpha by AIDS mononuclear cells after in vitro exposure to Rhodoccocus equi. Mediators Inflamm. 1995;4(4):306–9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2365645'}, {'@IdType': 'pubmed', '#text': '18475656'}]}}",
"{'Citation': 'Achenbach CJ, Harrington RD, Dhanireddy S, et al. Paradoxical immune reconstitution inflammatory syndrome in HIV-infected patients treated with combination antiretroviral therapy after AIDS-defining opportunistic infection. Clin Infect Dis. 2012;54(3):424–33.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3258272'}, {'@IdType': 'pubmed', '#text': '22095568'}]}}",
"{'Citation': 'Huis in’t Veld D, Sun HY, Hung CC, Colebunders R. The immune reconstitution inflammatory syndrome related to HIV Co-Infections: A review. Eur J Clin Microbiol Infect Dis. 2012;31:919–27.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21964588'}}}",
"{'Citation': 'Grant P, Komarow L, Sereti I, et al. Risk factor analyses for immune reconstitution inflammatory syndrome and mortality during a randomized trial of early versus deferred ART in the setting of acute opportunistic infections: ACTG A5164. Sixteenth Conference on Retroviruses and Opportunistic Infections; February 8–11 2009; Montreal, Canada.'}",
"{'Citation': 'Shelburne SA, 3rd, Darcourt J, White AC, Jr, et al. The role of immune reconstitution inflammatory syndrome in AIDS-related Cryptococcus neofor-mans disease in the era of highly active antiretroviral therapy. Clin Infect Dis. 2005;40(7):1049–52.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15825000'}}}"
] | Am J Case Rep. 2017 Jan 19; 18:67-71 | NO-CC CODE |
|
Filling defect in the right lower lobe branch along with “air-contrast”. | amjcaserep-18-80-g004 | 7 | 0ee68cc3f90dcf0dafafdc594c503a84613750fffb4bcca2de11c6d1fa13f6b8 | amjcaserep-18-80-g004.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
640,
520
] | [{'image_id': 'amjcaserep-18-80-g002', 'image_file_name': 'amjcaserep-18-80-g002.jpg', 'image_path': '../data/media_files/PMC5282968/amjcaserep-18-80-g002.jpg', 'caption': 'Air and contrast in the main pulmonary artery and major divisions.', 'hash': '4483464ed1e753f34e44d399d5b23a9c15d4e25115709c8817e485cfa290c6e3'}, {'image_id': 'amjcaserep-18-80-g004', 'image_file_name': 'amjcaserep-18-80-g004.jpg', 'image_path': '../data/media_files/PMC5282968/amjcaserep-18-80-g004.jpg', 'caption': 'Filling defect in the right lower lobe branch along with “air-contrast”.', 'hash': '0ee68cc3f90dcf0dafafdc594c503a84613750fffb4bcca2de11c6d1fa13f6b8'}, {'image_id': 'amjcaserep-18-80-g003', 'image_file_name': 'amjcaserep-18-80-g003.jpg', 'image_path': '../data/media_files/PMC5282968/amjcaserep-18-80-g003.jpg', 'caption': 'Filling defect in the right lower lobe branch.', 'hash': 'd7d81a348094ec6ae5c112ebb0305d6c8a712c3473daf645692eb00caa61f19a'}, {'image_id': 'amjcaserep-18-80-g001', 'image_file_name': 'amjcaserep-18-80-g001.jpg', 'image_path': '../data/media_files/PMC5282968/amjcaserep-18-80-g001.jpg', 'caption': 'Air embolus in the right atrium and ventricle.', 'hash': 'faa2279c20cf361d7f7df88f45f798288999c42486b33deb4a4c0ba95ce8ae08'}] | {'amjcaserep-18-80-g001': ['During CT about 100–150 mL of air was inadvertently injected through the right antecubital vein using a power contrast injector (estimated by the technician and approximation of volumes on available imaging). Concurrent imaging (CT) showed a significant amount of air in the right atrium and right ventricular cavity (<xref ref-type="fig" rid="amjcaserep-18-80-g001">Figure 1</xref>), and air mixed with contrast in the main pulmonary artery and its proximal branches divisions of the pulmonary circulation (), and air mixed with contrast in the main pulmonary artery and its proximal branches divisions of the pulmonary circulation (<xref ref-type="fig" rid="amjcaserep-18-80-g002">Figure 2</xref>). Concurrently, a filling defect was noted in the right lower lobe artery consistent with pulmonary thromboembolism (). Concurrently, a filling defect was noted in the right lower lobe artery consistent with pulmonary thromboembolism (<xref ref-type="fig" rid="amjcaserep-18-80-g003">Figures 3</xref>, , <xref ref-type="fig" rid="amjcaserep-18-80-g004">4</xref>). The patient maintained hemodynamic stability with Trendelenburg, and left lateral decubitus positioning (Durant’s maneuver), and supportive care alone and she was transferred to the intensive care unit (ICU) for observation. Her respiratory distress worsened, and she was placed temporarily on non-invasive positive pressure ventilation (NIPPV) without improvement and a few hours later she was intubated and placed on mechanical ventilation. Intravenous full dose heparin infusion (initial bolus, 80 units/kg, followed by 18 units/kg/hour) was initiated for treatment of concurrent thromboembolism. Echocardiography did not show any evidence of right or left ventricular failure. Subsequent echocardiography done 24 hours later did not show any evidence of intracardiac air and complete resolution of the air embolism.). The patient maintained hemodynamic stability with Trendelenburg, and left lateral decubitus positioning (Durant’s maneuver), and supportive care alone and she was transferred to the intensive care unit (ICU) for observation. Her respiratory distress worsened, and she was placed temporarily on non-invasive positive pressure ventilation (NIPPV) without improvement and a few hours later she was intubated and placed on mechanical ventilation. Intravenous full dose heparin infusion (initial bolus, 80 units/kg, followed by 18 units/kg/hour) was initiated for treatment of concurrent thromboembolism. Echocardiography did not show any evidence of right or left ventricular failure. Subsequent echocardiography done 24 hours later did not show any evidence of intracardiac air and complete resolution of the air embolism.']} | Pulmonary Air Embolism: An Infrequent Complication in the Radiology Suite | [
"Anoxia",
"Embolism, Air",
"Hyperbaric Oxygenation"
] | Am J Case Rep | 1485244800 | Colonoscopies can predict long-term prognoses in patients with ulcerative colitis (UC). Recently, a new imaging technology has been developed that uses 3 types of illumination with center wavelengths of 540 nm, 600 nm, and 630 nm. The use of both the 600-nm and 630-nm lights (Dual red imaging; DRI) is critical for identifying blood vessels in deeper tissue. The aim of this study was to evaluate the usefulness of DRI for assessing the severity of inflammation in patients with UC. A total of 43 UC patients were retrospectively enrolled to evaluate the endoscopic severity of 112 colon segments, and Mayo endoscopic scores, DRI scores and the severity of inflammation on a visual analogue scale (VAS) were compared. The Mayo endoscopic scores, DRI scores, and histologic scores were evaluated, and the interobserver agreement on DRI scores among 5 investigators was also assessed. The usefulness of DRI scores for predicting prognoses was also assessed in patients with clinical remission. The DRI scores were closely correlated with the VAS for the severity of colonic inflammation (r = 0.96) and the histologic scores (r = 0.72 - 0.8). The DRI scores had a higher rate of interobserver agreement (κ values = 0.63 - 0.88) than the Mayo endoscopic scores (κ values = 0.44 - 0.59). Inter-observer agreement between 4 non-experts was also excellent (mean κ value = 0.76, range 0.63 - 0.82). The expected time until recurrence was significantly longer in patients with lower DRI scores ( < 0.01). DRI can be used in patients with mild to moderate endoscopic severity because it targets the deep vascular pattern. The prognosis of UC can be predicted by assessing deep vessels using DRI. | [] | other | PMC5282968 | null | 20 | [
"{'Citation': 'Yoshida T, Inoue H, Usui S et al.Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions. Gastrointest Endosc. 2004;59:288–295.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14745410'}}}",
"{'Citation': 'Gono K, Obi T, Yamaguchi M et al.Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt. 2004;9:568–577.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15189095'}}}",
"{'Citation': 'Muto M, Minashi K, Yano T et al.Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. Clin Oncol. 2010;28:1566–1572.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2849774'}, {'@IdType': 'pubmed', '#text': '20177025'}]}}",
"{'Citation': 'Sano Y, Horimatsu T, Fu K I et al.Magnifying observation of microvascular architecture of colorectal lesions using a narrow band imaging system. Dig Endosc. 2006;18:44–S51.'}",
"{'Citation': 'Katagiri A, Fu K I, Sano Y et al.Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia. Aliment Pharmacol Ther. 2008;27:1269–1274.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18284647'}}}",
"{'Citation': 'Yahagi N. Dual Red Imaging; A new endoscopic imaging technology for clear visualization of bleeding points in endoscopic submucosal dissection. Gastrointestinal Endosc. 2014:A1192.'}",
"{'Citation': 'Horii J, Uraoka T, Goto O et al.Dual Red Imaging; A new endoscopic imaging technology for clear visualization of thick blood vessels in deeper tissue and bleeding points. Gastrointestinal Endosc. 2014:A3116.'}",
"{'Citation': 'Yao T, Matsui T, Hiwatashi N. Crohn’s disease in Japan: diagnostic criteria and epidemiology. Dis Colon Rectum. 2000;43:85–S93.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11052483'}}}",
"{'Citation': 'Schroeder K W, Tremaine W J, Ilstrup D M. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317:1625–1629.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3317057'}}}",
"{'Citation': 'Geboes K, Riddell R, Ost A et al.A reproducible grading scale for histological assessment of inflammation in ulcerative colitis. Gut. 2000;47:404–409.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1728046'}, {'@IdType': 'pubmed', '#text': '10940279'}]}}",
"{'Citation': 'Neurath M F, Travis S P. Mucosal healing in inflammatory bowel diseases: a systematic review. Gut. 2012;61:1619–1635.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22842618'}}}",
"{'Citation': 'Ardizzone S, Cassinotti A, Duca P et al.Mucosal healing predicts late outcomes after the first course of corticosteroids for newly diagnosed ulcerative colitis. Clin Gastroenterol Hepatol. 2011;9:483–489.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21195796'}}}",
"{'Citation': 'Arias M T, Vande Casteele N, Vermeire S et al.A panel to predict long-term outcome of infliximab therapy for patients with ulcerative colitis. Clin Gastroenterol Hepatol. 2015;13:531–538.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '25117777'}}}",
"{'Citation': 'Colombel J F, Rutgeerts P, Reinisch W et al.Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141:1194–1201.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21723220'}}}",
"{'Citation': 'Baron J H, Connell A M, Lennard-Jones J E. Variation between observers in describing mucosal appearances in proctocolitis. Br Med J. 1964;1:89–99.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1812908'}, {'@IdType': 'pubmed', '#text': '14075156'}]}}",
"{'Citation': 'Hawthorne A B, Logan R F, Hawkey C J et al.Randomised controlled trial of azathioprine withdrawal in ulcerative colitis. BMJ. 1992;305:20–22.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1882467'}, {'@IdType': 'pubmed', '#text': '1638191'}]}}",
"{'Citation': 'Schroeder K W, Tremaine W J, Ilstrup D M. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317:1625–1629.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3317057'}}}",
"{'Citation': 'Travis S P, Schnell D, Krzeski P et al.Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) Gut. 2012;61:535–544.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3292713'}, {'@IdType': 'pubmed', '#text': '21997563'}]}}",
"{'Citation': 'Travis S P, Schnell D, Krzeski P et al.Reliability and initial validation of the ulcerative colitis endoscopic index of severity. Gastroenterology. 2013;145:987–995.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23891974'}}}",
"{'Citation': 'Samuel S, Bruining D H, Loftus E V, Jr et al.Validation of the ulcerative colitis colonoscopic index of severity and its correlation with disease activity measures. Clin Gastroenterol Hepatol. 2013;11:49–54.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC10602401'}, {'@IdType': 'pubmed', '#text': '22902762'}]}}"
] | Am J Case Rep. 2017 Jan 24; 18:80-84 | NO-CC CODE |
|
a: sagittal MR image of the patient showing the CSF leak through the ethmoid cells – white arrow; b: the proper – green line – and the inappropriate – red line – routes for the nasal swab testing. | gr1_lrg | 7 | 5d1f3f686b0e14bfe1f9fd193925786772b78623d802a1823b36f35478e2177a | gr1_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
343
] | [{'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC8379084/gr1_lrg.jpg', 'caption': 'a: sagittal MR image of the patient showing the CSF leak through the ethmoid cells\xa0–\xa0white arrow; b: the proper\xa0–\xa0green line\xa0–\xa0and the inappropriate\xa0–\xa0red line\xa0–\xa0routes for the nasal swab testing.', 'hash': '5d1f3f686b0e14bfe1f9fd193925786772b78623d802a1823b36f35478e2177a'}] | {'gr1_lrg': ['A 45-year-old woman presented to the neurosurgery outpatient clinic in October 2020 with continuous rhinorrhea that increases with maneuvers end up with an increase in the intracranial pressure. The patient had a history of nasal swab testing for COVID-19 20 days before admission to the hospital. The rhinorrhea had started shortly after the nasal swab testing in another clinic and the patient has been prescribed acetazolamide which decreased the amount of rhinorrhea but could not solve the problem. Cranial MR evaluation showed that a clear CSF passage from the anterior ethmoidal air cells (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>a). The decision was following the patient with lumbar drainage as a non-surgical treatment option for the defect. Patient\'s rhinorrhea has been ceased after the insertion of the lumbar drainage. The patient was followed for 10 days with lumbar drainage. After 10 days of drainage, the drain was terminated for 24 hours. After the termination of the drainage, no more rhinorrhea has been observed and the patient was discharged after the lumbar drainage had been removed. She is under follow up without any recurring rhinorrhea after 9 months from the treatment.a). The decision was following the patient with lumbar drainage as a non-surgical treatment option for the defect. Patient\'s rhinorrhea has been ceased after the insertion of the lumbar drainage. The patient was followed for 10 days with lumbar drainage. After 10 days of drainage, the drain was terminated for 24 hours. After the termination of the drainage, no more rhinorrhea has been observed and the patient was discharged after the lumbar drainage had been removed. She is under follow up without any recurring rhinorrhea after 9 months from the treatment.Fig. 1a: sagittal MR image of the patient showing the CSF leak through the ethmoid cells\xa0–\xa0white arrow; b: the proper\xa0–\xa0green line\xa0–\xa0and the inappropriate\xa0–\xa0red line\xa0–\xa0routes for the nasal swab testing.', 'The nasal swab test is considered as a safe test that is performed by approximately 61.5 million people in Turkey and 218,000 people daily as of July 3, 2021 [7]. The nasal swab test is relatively easy to perform and requires inconsiderable amount of training. The proper way of insertion of the swab should be parallel to the hard palate until a resistance is felt [8] (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>b\xa0–\xa0green line). The swab should not be directed upwards (b\xa0–\xa0green line). The swab should not be directed upwards (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>b\xa0–\xa0red line) as it is not possible to collect the required specimen from the nasopharynx and can damage the ethmoidal air cells and as a result causing rhinorrhea as seen in our patient.b\xa0–\xa0red line) as it is not possible to collect the required specimen from the nasopharynx and can damage the ethmoidal air cells and as a result causing rhinorrhea as seen in our patient.']} | Iatrogenic rhinorrhea by nasal swab testing during COVID-19 pandemic: Case report | null | Neurochirurgie | 1650524400 | None | null | other | PMC8379084 | null | null | [
""
] | Neurochirurgie. 2022 Apr 21; 68(3):347-348 | NO-CC CODE |
|
Coronal reformatted CT image demonstrates duodenal thickening due to inflammation. | poljradiol-81-589-g002 | 7 | 193f01444593194e0a5b6c67de6eb492404dcb95fb4648f685453208e776be89 | poljradiol-81-589-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
600
] | [{'image_id': 'poljradiol-81-589-g004', 'image_file_name': 'poljradiol-81-589-g004.jpg', 'image_path': '../data/media_files/PMC5147682/poljradiol-81-589-g004.jpg', 'caption': 'Follow-up axial contrast enhanced CT scan reveals complete resolution of the findings.', 'hash': '32315f93680ee493a527e56235aaf9e8587f8c4ad5e6a68d1bc3ffc57752f6b3'}, {'image_id': 'poljradiol-81-589-g003', 'image_file_name': 'poljradiol-81-589-g003.jpg', 'image_path': '../data/media_files/PMC5147682/poljradiol-81-589-g003.jpg', 'caption': 'Axial unenhanced CT image of the lower part of the duodenum demonstrates a small amount of right paraduodenal fluid collection. The density of fluid collection indicates etiology other than hemorrhage.', 'hash': 'fe6bc06bac9a9d5b1763889ece17415718263d33d0d15a67945099366b9b2977'}, {'image_id': 'poljradiol-81-589-g002', 'image_file_name': 'poljradiol-81-589-g002.jpg', 'image_path': '../data/media_files/PMC5147682/poljradiol-81-589-g002.jpg', 'caption': 'Coronal reformatted CT image demonstrates duodenal thickening due to inflammation.', 'hash': '193f01444593194e0a5b6c67de6eb492404dcb95fb4648f685453208e776be89'}, {'image_id': 'poljradiol-81-589-g005', 'image_file_name': 'poljradiol-81-589-g005.jpg', 'image_path': '../data/media_files/PMC5147682/poljradiol-81-589-g005.jpg', 'caption': 'Axial CT images of the same patient at different time points. Duodenal diverticulum (arrow) arising from the third portion of the duodenum is seen only in a single CT study (arrows in axial and reformatted unenhanced CT images) suggesting that duodenal diverticulum may not always be apparent on CT images.', 'hash': '063fb4dd74dccee61e6c2fa2b350cbf8749d195314332abda799e9dbf0c8120e'}, {'image_id': 'poljradiol-81-589-g001', 'image_file_name': 'poljradiol-81-589-g001.jpg', 'image_path': '../data/media_files/PMC5147682/poljradiol-81-589-g001.jpg', 'caption': 'Acute duodenitis following diagnostic upper gastrointestinal endoscopy. Axial unenhanced CT scan at the level of the third part of duodenum demonstrates extensive duodenal inflammation (white arrows) and periduodenal fat stranding. Compression of the inferior vena cava is also noted (black arrow).', 'hash': '7352d2d945093f199ef695a5577d6d236993a1a3d513448d5fb260b3fbad2eee'}] | {'poljradiol-81-589-g001': ['A 67-year-old woman was admitted to the emergency room with a one-week history of left lower quadrant abdominal pain. Initial CT examination revealed acute sigmoid colonic diverticulitis. Follow-up CT examinations demonstrated regression of the colonic diverticulitis. Upper GI endoscopy and colonoscopy were scheduled before discharge. Although both procedures were performed uneventful, the patient developed epigastric pain and dyspeptic complaints on the next day after the UGI endoscopy. The symptoms did not resolve or worsen on follow-up. A CT examination was performed on the fourth day after the UGI endoscopy to rule out potential complications, which demonstrated extensive duodenal inflammation without signs of perforation (<xref ref-type="fig" rid="poljradiol-81-589-g001">Figures 1</xref>, , <xref ref-type="fig" rid="poljradiol-81-589-g002">2</xref>). The laboratory results did not support the presence of hemorrhage or inflammation. However, the patient was treated for acute sigmoid diverticulitis, and therefore clinical and laboratory findings were not reliable. The diagnosis of acute duodenitis was made based on CT findings. The density of the paraduodenal fluid collection (8 HU) also diminished the possibility of hemorrhage (). The laboratory results did not support the presence of hemorrhage or inflammation. However, the patient was treated for acute sigmoid diverticulitis, and therefore clinical and laboratory findings were not reliable. The diagnosis of acute duodenitis was made based on CT findings. The density of the paraduodenal fluid collection (8 HU) also diminished the possibility of hemorrhage (<xref ref-type="fig" rid="poljradiol-81-589-g003">Figure 3</xref>). It is more likely that the antibiotics and anti-inflammatory agents administered for the acute sigmoid diverticulitis were also efficient for duodenal diverticulitis. Therefore, no additional treatment was necessary, and the patient’s clinical status improved significantly with conservative treatment. A follow-up CT scan performed three days later demonstrated complete resolution of the findings (). It is more likely that the antibiotics and anti-inflammatory agents administered for the acute sigmoid diverticulitis were also efficient for duodenal diverticulitis. Therefore, no additional treatment was necessary, and the patient’s clinical status improved significantly with conservative treatment. A follow-up CT scan performed three days later demonstrated complete resolution of the findings (<xref ref-type="fig" rid="poljradiol-81-589-g004">Figure 4</xref>).).'], 'poljradiol-81-589-g005': ['A duodenal diverticulum arising from the third portion of the duodenum was demonstrated on CT (<xref ref-type="fig" rid="poljradiol-81-589-g005">Figure 5</xref>). Moreover, duodenal inflammation was also localized to the same part of the duodenum. However, the diverticulum was seen only on a single CT scan.). Moreover, duodenal inflammation was also localized to the same part of the duodenum. However, the diverticulum was seen only on a single CT scan.'], 'poljradiol-81-589-g003': ['Our patient’s clinical status and imaging findings demonstrated rapid improvement (within a week). Rapid radiological improvement supports the lack of hemorrahge, since duedenal hematomas are expected to resolve in 1–3 weeks [3]. On the other hand, one may speculate that the reported rate of acute duodenitis following diagnostic UGI endoscopy could be underestimated considering such a rapid recovery. For instance,, if a timely follow-up imaging had not been obtained in our patient, the duodenitis could have been unnoticed.. However, further studies are warranted to confirm our observation. The next issue that should be addressed is whether a duodenal diverticulum is a predisposing factor for acute duodenitis following diagnostic UGI endoscopy. Although duodenal diverticulum substantially increases the risk of perforation [1,2], patients with diverticuli may also present with diverticulitis and duodenal inflammation [4,5]. However, it should be noted that inflammation due to diverticulitis is predominantly local [3,5]. Nevertheless, the reported cases of duodenal diverticulitis, in general, had not had a history of any predisposing invasive procedure. Our patient had a duodenal diverticulum arising from the third portion of the duodenum where inflammation was also localized.. Therefore, we speculate that the presence of a duodenal diverticulum may predispose to acute duodenitis following diagnostic UGI endoscopy. Currently, there is no consensus as to what procedure constitutes the gold standard for the diagnosis of a duodenal diverticulum. There is inconsistency between clinical and post-mortem studies concerning the incidence of duondenal diverticulum [4,5]. The duodenal diverticulum does not consist of tunica muscularis (false diverticle) and is formed mainly by a protrusion through a focal weakness in the duodenal wall [4,5]. Consequently, a distinct contour may not always be apparent on CT images (<xref ref-type="fig" rid="poljradiol-81-589-g003">Figure 3</xref>). Therefore, the incidence of duodenal diverticulum may be underestimated by imaging as compared to autopsy studies.). Therefore, the incidence of duodenal diverticulum may be underestimated by imaging as compared to autopsy studies.']} | Acute Reversible Duodenitis Following Non-Therapeutic Upper Gastrointestinal Endoscopy. Is Duodenal Diverticulum a Predisposing Factor? | [
"Diverticulum",
"Duodenitis",
"Endoscopy, Gastrointestinal",
"Postoperative Complications"
] | Pol J Radiol | 1481097600 | None | null | other | PMC5147682 | null | null | [
""
] | Pol J Radiol. 2016 Dec 7; 81:589-592 | NO-CC CODE |
|
The sagittal T2 image (TE= 99, TR = 3500) demonstrates a high signal lentiform epidural collection situated posterior to the spinal cord. | or-2009-1-e1-g002 | 7 | 072672883be668cf2211d39a117b5ed44d577ee46bd19380033ba247e368e621 | or-2009-1-e1-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
666,
793
] | [{'image_id': 'or-2009-1-e1-g001', 'image_file_name': 'or-2009-1-e1-g001.jpg', 'image_path': '../data/media_files/PMC3143966/or-2009-1-e1-g001.jpg', 'caption': 'The axial T2 image (TE= 108, TR= 5820) demonstrates a high signal epidural collection which effaces the spinal cord anterior laterally.', 'hash': '0f218c23ae6193e06cb04e13bdb495a6df32c7c0144bdf3a75abeac3a19b0e16'}, {'image_id': 'or-2009-1-e1-g002', 'image_file_name': 'or-2009-1-e1-g002.jpg', 'image_path': '../data/media_files/PMC3143966/or-2009-1-e1-g002.jpg', 'caption': 'The sagittal T2 image (TE= 99, TR = 3500) demonstrates a high signal lentiform epidural collection situated posterior to the spinal cord.', 'hash': '072672883be668cf2211d39a117b5ed44d577ee46bd19380033ba247e368e621'}] | {'or-2009-1-e1-g001': ['Immediately after admission the patient underwent an MRI scan (see <xref ref-type="fig" rid="or-2009-1-e1-g001">Figures 1</xref> and and <xref ref-type="fig" rid="or-2009-1-e1-g002">2</xref>) for further evaluation of his back pain. This demonstrated a left posterior epidural collection from C6 to T5 with narrowing of the central canal and cord compression. This was most marked at T3 where the collection had a depth of 9 mm. The cranial end of the collection lay posteriorly to the thecal sac and reached the right side of the central canal. The epidural collection partially extended through the C7/T1/2 neural exit foramina bilaterally. There was an abnormal signal of the right paravertebral muscles closely adjacent to laminae of the mid and lower cervical spine and there was a small collection on the lateral aspect of the right C6/7 facet joint. There were no further soft tissue collections and no abnormal signal in the adjacent vertebrae.) for further evaluation of his back pain. This demonstrated a left posterior epidural collection from C6 to T5 with narrowing of the central canal and cord compression. This was most marked at T3 where the collection had a depth of 9 mm. The cranial end of the collection lay posteriorly to the thecal sac and reached the right side of the central canal. The epidural collection partially extended through the C7/T1/2 neural exit foramina bilaterally. There was an abnormal signal of the right paravertebral muscles closely adjacent to laminae of the mid and lower cervical spine and there was a small collection on the lateral aspect of the right C6/7 facet joint. There were no further soft tissue collections and no abnormal signal in the adjacent vertebrae.']} | Spinal epidural abscess: a rare complication of olecranon bursitis | [
"spinal epidural abscess",
"olecranon bursitis",
"Staphylococcus aureus."
] | Orthop Rev (Pavia) | 1246345200 | Multiple insufficiency fractures occurred in two patients with mutilating rheumatoid arthritis (RA), leading to substantial disabilities. Both patients received long-term oral glucocorticoid therapy and underwent multiple lower-extremity surgeries such as total hip arthroplasty (THA) or Total knee arthroplasty (TKA). The multiple fractures were located in the pelvis and lumbosacral region. Fractures in both patients were treated conservatively. Although bony union and resumption of activities were achieved in one patient, the other patient was not able to resume ambulation. For RA patients with combined risk factors for insufficiency fractures, aggressive preventive intervention and careful clinical assessment for early detection and management are warranted. | [] | other | PMC3143966 | null | 19 | [
"{'Citation': 'Soubrier M, Dubost JJ, Boisgard S, et al. Insufficiency fracture. A survey of 60 cases and review of the literature. Joint Bone Spine. 2003;70:209–18.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12814764'}}}",
"{'Citation': 'Nampei A, Hashimoto J, Koyanagi J, et al. Characteristics of fracture and related factors in patients with rheumatoid arthritis. Mod Rheumatol. 2008;18:170–6.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18297237'}}}",
"{'Citation': 'Christiansen CG, Kassim RA, Callaghan JJ, et al. Pubic ramus insufficiency fractures following total hip arthroplasty. A report of six cases. J Bone Joint Surg Am. 2003;85:1819–22.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12954846'}}}",
"{'Citation': 'Arafat QW, Davies AM. Parasymphyseal insufficiency fracture. Ann Rheum Dis. 1994;53:421–4.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1005359'}, {'@IdType': 'pubmed', '#text': '8037501'}]}}",
"{'Citation': 'Dasgupta B, Shah N, Brown H, et al. Sacral insufficiency fracture: an unsuspected cause of low back pain. Br J Rheumatol. 1998;37:789–93.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9714359'}}}",
"{'Citation': 'Gotis-Graham I, McGuigan L, Diamond T, et al. Sacral insufficiency fractures in the elderly. J Bone Joint Surg Br. 1994;76:882–6.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7983111'}}}",
"{'Citation': 'Mathers DM, Major GA, Allen L, et al. Insufficiency fracture of the sacrum. Ann Rheum Dis. 1993;52:621–3.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1005126'}, {'@IdType': 'pubmed', '#text': '8215631'}]}}",
"{'Citation': 'Schapira D, Militeanu D, Israel O, et al. Insufficiency fractures of the pubic ramus. Semin Arthritis Rheum. 1996;25:373–382.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8792509'}}}",
"{'Citation': 'West SG, Troutner JL, Baker MR, et al. Sacral insufficiency fractures in rheumatoid arthritis. Spine. 1994;19:2117–21.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7825055'}}}",
"{'Citation': 'Mather HG. Unusual rheumatoid arthritis (arthritis mutilans) Proc R Soc Med. 1954;47:457–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '13177555'}}}",
"{'Citation': 'Ochi T, Iwase R, Yonemasu K, et al. Natural course of joint destruction and fluctuation of serum C1q levels in patients with rheumatoid arthritis. Arthritis Rheum. 1988;31:37–43.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3257874'}}}",
"{'Citation': 'Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn. 1977;18:481–91.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '920239'}}}",
"{'Citation': 'van Staa TP, Leufkens HG, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporosis Int. 2002;13:777–87.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12378366'}}}",
"{'Citation': 'Verstraeten A, Dequeker J. Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with Rheumatoid arthritis: effect of low dose corticosteroids. Ann Rheum Dis. 1986;45:852–7.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1002008'}, {'@IdType': 'pubmed', '#text': '3789820'}]}}",
"{'Citation': 'NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785–95.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11176917'}}}",
"{'Citation': 'Nawata H, Soen S, Takayanagi R, et al. Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research (2004) J Bone Miner Metab. 2005;23:105–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15750687'}}}",
"{'Citation': 'Aretxabala I, Fraiz E, Pérez-Ruiz F, et al. Sacral insufficiency fractures High association with pubic rami fractures. Clin Rheumatol. 2000;19:399–401.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11055834'}}}",
"{'Citation': 'Davies AM, Evans NS, Struthers GR. Parasymphyseal and associated insufficiency fractures of the pelvis and sacrum. Br J Radiol. 1988;61:103–8.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3349247'}}}",
"{'Citation': 'Hoshino Y, Doita M, Yoshikawa M, et al. Unstable pelvic insufficiency fracture in a patient with rheumatoid arthritis. Rheumatol Int. 2004;24:46–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12748811'}}}"
] | Orthop Rev (Pavia). 2009 Jun 30; 1(1):e1 | NO-CC CODE |
|
A 53-year old patient with necrosis of the head of the femur with accompanying large bone marrow edema on the right side. Transcutaneous core decompression and BMAC transplantation. MRI controls after four and eight weeks. In addition to the clearly distinguishable drill channels, an almost complete normalization of the bone marrow signal can be seen. | or-2009-2-e32-g002 | 7 | ad332d5a9c1986b5106f4e8a281528ea2b560b6f26a31263040e824f3b176806 | or-2009-2-e32-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
449,
414
] | [{'image_id': 'or-2009-2-e32-g003', 'image_file_name': 'or-2009-2-e32-g003.jpg', 'image_path': '../data/media_files/PMC3143993/or-2009-2-e32-g003.jpg', 'caption': 'A 36-year old patient with necrosis of the head of the femur after DHS. BMAC transplantation with incipient subchondral fracture. During the further course of treatment, there was collapse of the femoral head followed by a total joint replacement.', 'hash': '4f248e809282aa869409c5646e3e4b405cb61cb5e0057f3e8f6231076b3eadd6'}, {'image_id': 'or-2009-2-e32-g004', 'image_file_name': 'or-2009-2-e32-g004.jpg', 'image_path': '../data/media_files/PMC3143993/or-2009-2-e32-g004.jpg', 'caption': 'An 86-year old female patient with periprosthetic fracture after total hip revision surgery showed a failure of LISS osteosynthesis. Re-osteosynthesis was combined with application of bone substitute material (CopiOs®) augmented by autologous BMAC. Despite good new bone formation, increasing axial deviation was noted after two months. Additional internal fixation by plate osteosynthesis from the anterior combined with a second CopiOs/BMAC transplantation was performed. Here, some tissue from the initial transplantation site was taken for histology. The patient showed a solid fusion of the fracture after a further three months post-operatively. The histological analysis of the transplantation site showed a significant new formation of woven bone (polarization optics, magnification × 200).', 'hash': '11003b2accd057179e76a00f06591bfc10fabf2afc9bbf1b6f26e084613c4e8b'}, {'image_id': 'or-2009-2-e32-g002', 'image_file_name': 'or-2009-2-e32-g002.jpg', 'image_path': '../data/media_files/PMC3143993/or-2009-2-e32-g002.jpg', 'caption': 'A 53-year old patient with necrosis of the head of the femur with accompanying large bone marrow edema on the right side. Transcutaneous core decompression and BMAC transplantation. MRI controls after four and eight weeks. In addition to the clearly distinguishable drill channels, an almost complete normalization of the bone marrow signal can be seen.', 'hash': 'ad332d5a9c1986b5106f4e8a281528ea2b560b6f26a31263040e824f3b176806'}, {'image_id': 'or-2009-2-e32-g001', 'image_file_name': 'or-2009-2-e32-g001.jpg', 'image_path': '../data/media_files/PMC3143993/or-2009-2-e32-g001.jpg', 'caption': 'Indications in 101 autologous mesenchymal stem cell transplantations. AVN: avascular necrosis.', 'hash': 'd46ebc621d3ac4952e631fdf90a10e58a2e54a4f7e3a334de9b91887f14ad1a0'}] | {'or-2009-2-e32-g001': ['A total of 101 patients (female/male: 48/53, mean age: 51 years) with bone healing disorders or osteonecrosis were surveyed in a prospective clinical surveillance study with additive application by BMAC. The indication for supportive therapy with BMAC was carried out in 37 cases due to necrosis of the head of the femur, and in 32 patients because of avascular osteonecrosis/bone marrow edema of another localization. BMAC was also used in 12 cases of non-unions and 20 times in bone healing disorders of another origin or for bone induction (arthrodesis of the upper ankle joint, humeral four-fragment fractures, and others)(<xref ref-type="fig" rid="or-2009-2-e32-g001">Figure 1</xref>).).'], 'or-2009-2-e32-g002': ['The post-operative treatment consisted of adequate medication for pain treatment, physiotherapeutic measures with relief of the lower extremities for four weeks as well as the partial loading with 20 kg for a further four weeks. In the case of avascular necrosis, post-operative MRI controls were carried out after four and eight weeks (<xref ref-type="fig" rid="or-2009-2-e32-g002">Figure 2</xref>).).'], 'or-2009-2-e32-g003': ['A male patient (age 36 years) had suffered a lateral fracture of the neck of the femur two years previously while playing football which had been treated using a dynamic hip screw. A radiologically confirmed necrosis of the femoral head with incipient subchondral fracture according to Association Research Circulation Osseous (ARCO) stage III was shown. The patient was offered a trial of BMAC cell therapy after clarification about the unfavourable mid-term prognosis of a joint-preserving therapy by means of core decompression. While the post-operative period was uneventful, within five months a further collapse of the femoral head occurred which required total joint replacement (<xref ref-type="fig" rid="or-2009-2-e32-g003">Figure 3</xref>).).'], 'or-2009-2-e32-g004': ['A female patient (age 86 years) had suffered a periprosthetic femur fracture caused by a fall after total hip replacement. The fracture had been treated by means of a less invasive stabilization system (LISS) plate. After two months, plate breakage occurred due to inadequate bone healing and was treated by re-osteosynthesis with bone substitute material and BMAC. After a further three months, an incipient axial deviation could be seen in the area around the operation site despite distinct new bone formation. An additional femur plate osteosynthesis from the anterior was inserted with additional bone substitute material and BMAC. Histological examination of tissue material from the former transplantation displayed a distinct formation of new woven bone. The fracture then healed uneventfully after a further three months (<xref ref-type="fig" rid="or-2009-2-e32-g004">Figure 4</xref>).).']} | Safety of autologous bone marrow aspiration concentrate transplantation: initial experiences in 101 patients | [
"bone marrow aspirate concentrate application."
] | Orthop Rev (Pavia) | 1255158000 | Background. Nonmotor symptoms (NMS) of Parkinson's disease (PD) may be more debilitating than motor symptoms. The purpose of this study was to determine the frequency and corecognition of NMS among our advanced PD cohort (patients considered for deep brain stimulation (DBS)) and caregivers. Methods. NMS-Questionnaire (NMS-Q), a self-administered screening questionnaire, and NMS Assessment-Scale (NMS-S), a clinician-administered scale, were administered to PD patients and caregivers. Results. We enrolled 33 PD patients (23 males, 10 females) and caregivers. The most frequent NMS among patients using NMS-Q were gastrointestinal (87.9%), sleep (84.9%), and urinary (72.7%), while the most frequent symptoms using NMS-S were sleep (90.9%), gastrointestinal (75.8%), and mood (75.8%). Patient/caregiver scoring correlations for NMS-Q and NMS-S were 0.670 (P < 0.0001) and 0.527 (P = 0.0016), respectively. Conclusion The frequency of NMS among advanced PD patients and correlation between patients and caregivers varied with the instrument used. The overall correlation between patient and caregiver was greater with NMS-Q than NMS-S. | [] | other | PMC3143993 | null | 5 | [
"{'Citation': 'Poewe W. Clinical measures of progression in Parkinson’s disease. Movement Disorders. 2009;24(2, supplement):S671–S676.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19877235'}}}",
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"{'Citation': 'Chaudhuri KR, Martinez-Martin P. Quantitation of non-motor symptoms in Parkinson’s disease. European Journal of Neurology. 2008;15(2, supplement):2–8.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18702736'}}}",
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] | Orthop Rev (Pavia). 2009 Oct 10; 1(2):e32 | NO-CC CODE |
|
Axial arterial phase (A) and portal venous phase (B) and sagittal portal venous phase (C) CECT images showing a complete intrapancreatic course of the portal vein (white arrows). Pancreatic duct is seen to course anteriorly to the portal vein (dotted white arrow in A). Axial BTFE MR image (D) also shows a complete intrapancreatic course of the portal vein. | poljradiol-82-38-g001 | 7 | 129583dd278c4a19802ab38833861f6345fbc36eb19469ecde7174cd70ad8167 | poljradiol-82-38-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
792,
924
] | [{'image_id': 'poljradiol-82-38-g001', 'image_file_name': 'poljradiol-82-38-g001.jpg', 'image_path': '../data/media_files/PMC5286926/poljradiol-82-38-g001.jpg', 'caption': 'Axial arterial phase (A) and portal venous phase (B) and sagittal portal venous phase (C) CECT images showing a complete intrapancreatic course of the portal vein (white arrows). Pancreatic duct is seen to course anteriorly to the portal vein (dotted white arrow in A). Axial BTFE MR image (D) also shows a complete intrapancreatic course of the portal vein.', 'hash': '129583dd278c4a19802ab38833861f6345fbc36eb19469ecde7174cd70ad8167'}, {'image_id': 'poljradiol-82-38-g002', 'image_file_name': 'poljradiol-82-38-g002.jpg', 'image_path': '../data/media_files/PMC5286926/poljradiol-82-38-g002.jpg', 'caption': 'Axial arterial phase CECT (A) and axial T2W MR (B) images showing a tortuous course of the pancreatic duct in the head region (dotted white arrows).', 'hash': 'b40da799997cab991d3786c4e1583628e088097ad42c01c75d3e8178966152e6'}] | {'poljradiol-82-38-g001': ['A 45-year-old male patient with chronic Budd Chiari disease presented for a triphasic computed tomography (CT) scan of the abdomen to rule out a mass lesion due to poor acoustic window and heterogeneous hepatic echotexture on sonography. The patient underwent contrast-enhanced CT in a 128 slice MDCT scanner (Ingenuity CT, Philips Healthcare, Cleveland, OH). The CT showed an intrapancreatic course of the portal vein with the pancreatic duct coursing anteriorly to it. The pancreatic duct was tortuous in the head region and was visualized partially. MRI was performed on a 1.5T MRI scanner (Philips Medical systems, the Netherlands), which revealed a tortuous course of the pancreatic duct without any evidence of divisum (<xref ref-type="fig" rid="poljradiol-82-38-g001">Figures 1</xref>, , <xref ref-type="fig" rid="poljradiol-82-38-g002">2</xref>). Based on the MDCT and MRI findings, a diagnosis of type III portal annular pancreas was made.). Based on the MDCT and MRI findings, a diagnosis of type III portal annular pancreas was made.']} | Portal Annular Pancreas: A Rare and Overlooked Anomaly | [
"Magnetic Resonance Imaging",
"Multidetector Computed Tomography",
"Pancreatic Ducts",
"Portal Vein"
] | Pol J Radiol | 1485244800 | Fluorescence anisotropy measurements of reagents compartmentalized into individual nanoliter droplets are shown to yield high-resolution binding curves from which precise dissociation constants (K) for protein-peptide interactions can be inferred. With the current platform, four titrations can be obtained per minute (based on ∼100 data points each), with stoichiometries spanning more than 2 orders of magnitude and requiring only tens of microliters of reagents. In addition to affinity measurements with purified components, K values for unpurified proteins in crude cell lysates can be obtained without prior knowledge of the concentration of the expressed protein, so that protein purification can be avoided. Finally, we show how a competition assay can be set up to perform focused library screens, so that compound labeling is not required anymore. These data demonstrate the utility of droplet compartments for the quantitative characterization of biomolecular interactions and establish fluorescence anisotropy imaging as a quantitative technique in a miniaturized droplet format, which is shown to be as reliable as its macroscopic test tube equivalent. | [] | other | PMC5286926 | null | 42 | [
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"{'Citation': 'Lach S.; Yoon S. M.; Grzybowski B. A. Chem. Soc. Rev. 2016, 45, 4766–96. 10.1039/C6CS00242K.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1039/C6CS00242K'}, {'@IdType': 'pubmed', '#text': '27293207'}]}}"
] | Pol J Radiol. 2017 Jan 24; 82:38-40 | NO-CC CODE |
|
Coronal MRI post-gadolinium enhancement showing the retroperitoneal lesion with a high signal rim (Black Arrow). | umj7802-129-f1b | 7 | 31d16ae3750ff7ca32d0cdbc4a2d0658b5192299314c5248a75e52807b647ff3 | umj7802-129-f1b.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
460,
563
] | [{'image_id': 'umj7802-129-f1b', 'image_file_name': 'umj7802-129-f1b.jpg', 'image_path': '../data/media_files/PMC2699201/umj7802-129-f1b.jpg', 'caption': 'Coronal MRI post-gadolinium enhancement showing the retroperitoneal lesion with a high signal rim (Black Arrow).', 'hash': '31d16ae3750ff7ca32d0cdbc4a2d0658b5192299314c5248a75e52807b647ff3'}, {'image_id': 'umj7802-129-f2', 'image_file_name': 'umj7802-129-f2.jpg', 'image_path': '../data/media_files/PMC2699201/umj7802-129-f2.jpg', 'caption': 'T2-weighted axial MRI comparable in position and image acquisition to Figure 1a demonstrating complete resolution of haematoma and IVC (White Arrow) without thrombus after 4-months of oral anticoagulation therapy.', 'hash': 'aa364e7881c559556a8ac9b8b30348bd2c561b3bda64351f5dd8648dd08d4e47'}, {'image_id': 'umj7802-129-f5', 'image_file_name': 'umj7802-129-f5.jpg', 'image_path': '../data/media_files/PMC2699201/umj7802-129-f5.jpg', 'caption': 'T2-weighted axial MRI showing apparent stenosis of IVC at renal level (Black Arrow).', 'hash': 'f79ec6deb22240c54870426f87434ac3d5b3fe10e08d71d6238ae98ca3a8bb68'}, {'image_id': 'umj7802-129-f1a', 'image_file_name': 'umj7802-129-f1a.jpg', 'image_path': '../data/media_files/PMC2699201/umj7802-129-f1a.jpg', 'caption': 'T2-weighted axial MRI demonstrating the mass (predominantly high signal) in the right retroperitoneal space anterior to psoas muscle between the IVC and right kidney (Black Arrow) compressing the overlying IVC (White Arrow).', 'hash': '8f909897336dcaa1d4c50c234fe854ecb876aaa5bfb1c941e308f704867fc524'}, {'image_id': 'umj7802-129-f4', 'image_file_name': 'umj7802-129-f4.jpg', 'image_path': '../data/media_files/PMC2699201/umj7802-129-f4.jpg', 'caption': 'Coronal gradient echo MRI showing atresia of IVC between renal and hepatic segments (Sequential White Arrows) with a patent hepatic and suprahepatic IVC (PSC). Extensive, well developed collateralisation through ascending lumbar veins, azygous system and anterior abdominal wall subcutaneous veins (LC).', 'hash': '00d41b090ee4f70ba2dad2bca0bc05af082f411550f4eb53b7e1268dfdfd02a1'}, {'image_id': 'umj7802-129-f3', 'image_file_name': 'umj7802-129-f3.jpg', 'image_path': '../data/media_files/PMC2699201/umj7802-129-f3.jpg', 'caption': 'T2-weighted MRI demonstrating iliofemoral thrombosis extending proximally into the infrarenal vena cava (White Arrow) with extensive collateralisation (C) around the upper retroperitoneum.', 'hash': '1b35059ab908e08839c972afe87a58609f8290086b88a6fe594b607e28088eb8'}] | {'umj7802-129-f1a': ['Doppler ultrasound confirmed bilateral common femoral vein thrombus. An IVC venogram via the right jugular vein demonstrated occlusion of the IVC inferior to the right atrium. Magnetic resonance imaging (MRI) suggested that the retroperitoneal mass was a haematoma which had been compressing the adjacent IVC. MRI also demonstrated intraluminal thrombus extending proximally up to the confluence of the hepatic veins immediately inferior to the right atrium with distal extension to the femoral veins bilaterally (<xref ref-type="fig" rid="umj7802-129-f1a">Figures 1a</xref> & & <xref ref-type="fig" rid="umj7802-129-f1b">b</xref>). Thrombophilia screen did not reveal any abnormality.). Thrombophilia screen did not reveal any abnormality.', 'T2-weighted axial MRI comparable in position and image acquisition to <xref ref-type="fig" rid="umj7802-129-f1a">Figure 1a</xref> demonstrating complete resolution of haematoma and IVC (White Arrow) without thrombus after 4-months of oral anticoagulation therapy. demonstrating complete resolution of haematoma and IVC (White Arrow) without thrombus after 4-months of oral anticoagulation therapy.'], 'umj7802-129-f2': ['The patient was treated conservatively with subcutaneous low molecular weight heparin followed by oral warfarin and the application of compression hosiery. Subsequent MRI imaging demonstrated complete resolution of the mass and return of full patency of the IVC at 4-months (<xref ref-type="fig" rid="umj7802-129-f2">Figure 2</xref>). It remains unclear whether the IVC thrombus was preceded by the haematoma or vice versa. It was felt on balance that treatment should be directed towards the thrombus, especially in view of the early scans indicating speedy resolution of the haematoma. His bilateral lower limb pain resolved at an early stage and the patient remains well two years later with regular vascular and haematological clinical review. Warfarin was discontinued after one year. Subsequent haematological evaluation did not reveal any thrombophilic predisposition.). It remains unclear whether the IVC thrombus was preceded by the haematoma or vice versa. It was felt on balance that treatment should be directed towards the thrombus, especially in view of the early scans indicating speedy resolution of the haematoma. His bilateral lower limb pain resolved at an early stage and the patient remains well two years later with regular vascular and haematological clinical review. Warfarin was discontinued after one year. Subsequent haematological evaluation did not reveal any thrombophilic predisposition.'], 'umj7802-129-f3': ['Doppler ultrasound of the femoral veins demonstrated marked expansion of both vessels with intra-luminal thrombus. A CT scan of the chest/abdomen/pelvis revealed atypical venous anatomy where the IVC appeared slit-like between the hepatic and renal segment associated with marked dilatation of the infra-renal IVC, both common iliac veins and both external iliac veins. MRI imaging confirmed the CT findings and revealed a well developed collateral pathway through lumbar, azygous, hemi-azygous and subcutaneous anterior abdominal wall veins suggestive of long-standing caval obstruction (<xref ref-type="fig" rid="umj7802-129-f3">Figures 3</xref> and and <xref ref-type="fig" rid="umj7802-129-f4">4</xref>). MRI also demonstrated IVC stenosis between the renal and hepatic segments, with a large thrombosed tortuous left renal vein, and no evidence of haematoma (). MRI also demonstrated IVC stenosis between the renal and hepatic segments, with a large thrombosed tortuous left renal vein, and no evidence of haematoma (<xref ref-type="fig" rid="umj7802-129-f5">Figure 5</xref>). The superficial renal portion of the IVC was narrowed thereby consistent with a congenital malformation of the IVC. A transthoracic echocardiogram did not reveal any intra-cardiac or aortic root anomaly. Thrombophilia screens, anti-cardiolipin antibodies, serum electrophoresis, direct Coomb\'s, auto-immune, complement, anti-neutrophil and immunoglobulin screens were normal.). The superficial renal portion of the IVC was narrowed thereby consistent with a congenital malformation of the IVC. A transthoracic echocardiogram did not reveal any intra-cardiac or aortic root anomaly. Thrombophilia screens, anti-cardiolipin antibodies, serum electrophoresis, direct Coomb\'s, auto-immune, complement, anti-neutrophil and immunoglobulin screens were normal.']} | Inferior Vena Cava Thrombosis in Young Adults – a review of two cases | [
"Deep vein thrombosis",
"inferior vena cava thrombus",
"retroperitoneal haematoma",
"congenital malformation"
] | Ulster Med J | 1241161200 | [{'@Label': 'OBJECTIVES', '@NlmCategory': 'OBJECTIVE', '#text': 'We describe a rare cause of posterior triangle cervical lymphadenopathy in a third decade female, outline the clinical and histopathological features and discuss excision biopsy as the investigation of choice in this age group, with lymphoma as the diagnosis of exclusion.'}, {'@Label': 'CASE REPORT', '@NlmCategory': 'METHODS', '#text': 'A thirty-four year old female was referred to our Head and Neck clinic with a one-month history of left posterior triangle lymphadenopathy. She reported no other symptoms and haematological investigations were normal. She was "Red Flagged" as a possible lymphoma. Excision biopsy revealed extensive histiocytic necrotising lymphadenitis providing a diagnosis of Kikuchi-Fujimoto disease.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'Persistent posterior triangle lymphadenopathy in the 16-40 year old age group warrants "Red Flag" referral to rule out serious pathology such as HIV, metastatic cancer or lymphoma. When the ENT examination and haematological work up is negative, we advocate proceeding straight to excision biopsy as the quickest way to obtain a diagnosis, which sometimes comes up with the unexpected as in this rare case of Kikuchi-Fujimoto disease.'}] | [
"Adult",
"Female",
"Histiocytic Necrotizing Lymphadenitis",
"Humans",
"Lymphoma"
] | other | PMC2699201 | null | 10 | [
"{'Citation': 'Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: a clinico-pathological study. [Japanese] Nippon Ketsueki Gakkai Zasshi. 1972;35:379–80.'}",
"{'Citation': 'Fujimoto Y, Kojima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. A new clinicopathological entity. Naika. 1972;20:920–7.'}",
"{'Citation': 'Pileri S, Kikuchi M, Helbron D, Lennert K. Histiocytic necrotizing lymphadenitis without granulocytic infiltration. Virchows Arch A Pathol Anat Histol. 1982;395(3):257–71.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7112935'}}}",
"{'Citation': 'Scheinfeld NS. Cutaneous Kikuchi disease. Updated Feb 12 2008. emedicine Medscape Available from: . Last accessed Feb 2009.'}",
"{'Citation': \"Qadri F, Atkin GK, Thomas D, Das S.K. Kikuchi's disease: an important cause of cervical lymphadenopathy. Clin Med. 2007;7(1):82–4.\", 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4953560'}, {'@IdType': 'pubmed', '#text': '17348583'}]}}",
"{'Citation': \"Dorfman RF, Berry GJ. Kikuchi's histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis. Semin Diagn Pathol. 1988;5(4):329–45.\", 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3217625'}}}",
"{'Citation': 'Imamura M, Ueno H, Matsuura A, Kamiya H, Suzuki T, Kikuchi K, et al. An ultrastructural study of subacute necrotizing lymphadenitis. Am J Pathol. 1982;107(3):292–9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1916249'}, {'@IdType': 'pubmed', '#text': '6282130'}]}}",
"{'Citation': 'Louis N, Hanley M, Davidson NM. Kikuchi-Fujimoto disease: a report of two cases and an overview. J Laryngol Otol. 1994;108(11):1001–4.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7829938'}}}",
"{'Citation': 'Garcia CE, Girdhar-Gopal HV, Dorfman DM. Kikuchi-Fujimoto disease of the neck. Update. Ann Otol Rhinol Laryngol. 1993;102(1):11–5.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8420463'}}}",
"{'Citation': \"Chang KL, Arber DA, Gaal KK, Weiss LM. Lymph nodes and spleen. In: Silverberg SG, DeLellis RA, Frable WJ, LiVolsi VA, Wick MR, editors. Silverberg's Principles and practice of surgical pathology and cytopathology. Volume 1. New York: Churchill Livingstone; 2006. pp. 507–607.\"}"
] | Ulster Med J. 2009 May; 78(2):129-133 | NO-CC CODE |
|
Coronal reformat reproduced from CTPA study demonstrating wide spread ground glass opacity (white arrows). | umj7802-137-f2a | 7 | 21fa2a643d8dcfeca99c0584e6fcba963ec86c1ed6c67cfeb72f283c4f9d63e4 | umj7802-137-f2a.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
460,
359
] | [{'image_id': 'umj7802-137-f1', 'image_file_name': 'umj7802-137-f1.jpg', 'image_path': '../data/media_files/PMC2699203/umj7802-137-f1.jpg', 'caption': 'Normal chest radiograph on admission.', 'hash': '8d1674fb91c8dadbc1f2fe6741494252b3ebe402a33163c8e4168a391763bd97'}, {'image_id': 'umj7802-137-f2b', 'image_file_name': 'umj7802-137-f2b.jpg', 'image_path': '../data/media_files/PMC2699203/umj7802-137-f2b.jpg', 'caption': 'Transaxial HRCT image at level of the carina showing intralobular interstitial thickening (black arrow), interlobular septal thickening (grey arrow) and ground glass opacity (white arrow).', 'hash': '17384e4a5d6f9a09957470aac298db131d5f6c17f2fbfd72171b02ae1695d428'}, {'image_id': 'umj7802-137-f3', 'image_file_name': 'umj7802-137-f3.jpg', 'image_path': '../data/media_files/PMC2699203/umj7802-137-f3.jpg', 'caption': 'Follow-up transaxial CT chest image demonstrating marked improvement in interstitial changes.', 'hash': '3657abcfcca59b5fe62d0bb0c157333bf0f597cdbcf714c77aba60476a842ff3'}, {'image_id': 'umj7802-137-f2a', 'image_file_name': 'umj7802-137-f2a.jpg', 'image_path': '../data/media_files/PMC2699203/umj7802-137-f2a.jpg', 'caption': 'Coronal reformat reproduced from CTPA study demonstrating wide spread ground glass opacity (white arrows).', 'hash': '21fa2a643d8dcfeca99c0584e6fcba963ec86c1ed6c67cfeb72f283c4f9d63e4'}] | {'umj7802-137-f1': ['A 62-year-old female with a history of polymyositis was admitted with a four-week history of increasing dyspnoea. She had been treated with maintenance oral steroid therapy over the previous 4 years, augmented with oral cyclophosphamide over the preceding 4 weeks. On examination there were fine crepitations to the mid-zones. The patient was hypoxic with a Pa02 of 10.2 KPa on inspired FiO2 of 0.6. C reactive protein was elevated at 212 mg/L. Echocardiogram was normal. Initial chest X-ray was normal (<xref ref-type="fig" rid="umj7802-137-f1">figure 1</xref>). A CT Pulmonary Angiogram (CTPA) was then performed and thrombus excluded, however inspiratory and expiratory high-resolution (HRCT) scans were obtained subsequent to the CTPA due to the grossly abnormal appearance of the lung parenchyma on lung windows. High resolution scan images demonstrated widespread marked ground glass opacity with intra and interlobular septal thickening in keeping with a diffuse alveolitis (). A CT Pulmonary Angiogram (CTPA) was then performed and thrombus excluded, however inspiratory and expiratory high-resolution (HRCT) scans were obtained subsequent to the CTPA due to the grossly abnormal appearance of the lung parenchyma on lung windows. High resolution scan images demonstrated widespread marked ground glass opacity with intra and interlobular septal thickening in keeping with a diffuse alveolitis (<xref ref-type="fig" rid="umj7802-137-f2a">figure 2a</xref> and and <xref ref-type="fig" rid="umj7802-137-f2b">2b</xref>). Ground glass opacification describes the findings on HRCT of the lungs in which there is a hazy increased attenuation of lung with preservation of bronchial and vascular margins. This appearance can be caused by partial filling of air spaces, interstitial thickening, partial collapse of alveoli, normal expiration, or increased capillary blood volume). Ground glass opacification describes the findings on HRCT of the lungs in which there is a hazy increased attenuation of lung with preservation of bronchial and vascular margins. This appearance can be caused by partial filling of air spaces, interstitial thickening, partial collapse of alveoli, normal expiration, or increased capillary blood volume1. The presence of numerous intra and interlobular septa almost always indicate the presence of an interstitial abnormality, only a few septa should be visible in normal patients. Septal thickening can be seen in the presence of interstitial fluid, cellular infiltration or fibrosis2. Diffuse alveolitis refers to the combination of these appearances throughout both lung fields suggestive of an acute inflammatory process of the pulmonary alveoli.'], 'umj7802-137-f3': ['The patient subsequently required intubation and ventilation; EBV was identified on endotracheal aspirate with a copy number of 28,420/ml on quantitative PCR. No other bacterial, viral or fungal infection was identified. The patient was then treated with IV Aciclovir with subsequent dramatic clinical and radiological improvement (<xref ref-type="fig" rid="umj7802-137-f3">figure 3</xref>). EBV was not detectable on repeat airway aspirate following treatment.). EBV was not detectable on repeat airway aspirate following treatment.']} | Epstein - Barr virus Pneumonitis | [
"Epstein-Barr virus",
"Pneumonitis",
"Computed Tomography",
"Lung",
"Aciclovir"
] | Ulster Med J | 1241161200 | [
"Acute Disease",
"Campylobacter Infections",
"Campylobacter jejuni",
"Drug Resistance, Multiple, Bacterial",
"Gastroenteritis",
"Humans",
"Northern Ireland"
] | other | PMC2699203 | null | 5 | [
"{'Citation': 'Food Standards Agency. A report of the study of infectious intestinal disease in England. London: The Stationary Office; 2000.'}",
"{'Citation': 'Moore JE, Crowe M, Heaney N, Crothers E. Antibiotic resistance in Campylobacter spp. isolated from human faeces (1980-2000) and foods (1997-2000) in Northern Ireland: an update. J Antimicrob Chemother. 2001;48(3):455–7.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11533022'}}}",
"{'Citation': 'Rao D, Rao JR, Crothers E, McMullan R, McDowell D, McMahon A, et al. Increased erythromycin resistance in clinical Campylobacter in Northern Ireland–an update. J Antimicrob Chemother. 2005;55(3):395–6.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15681584'}}}",
"{'Citation': 'Wilson IG. Antibiotic resistance of Campylobacter in raw retail chickens and imported chicken portions. Epidemiol Infect. 2003;131(3):1181–6.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2870068'}, {'@IdType': 'pubmed', '#text': '14959786'}]}}",
"{'Citation': 'Van Looveren M, Daube G, De Zutter L, Dumont JM, Lammens C, Wijdooghe M, et al. Antimicrobial susceptibilities of Campylobacter strains isolated from food animals in Belgium. J Antimicrob Chemother. 2001;48(2):235–40.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11481294'}}}"
] | Ulster Med J. 2009 May; 78(2):137-138 | NO-CC CODE |
||
CT angiogram images demonstrating a filling defect within the left internal jugular vein. | bcr-2020-239269f04 | 7 | 6bc19febf047fcdc50e87f360e2ff24278bea26e6230adac3215342620656318 | bcr-2020-239269f04.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
794,
298
] | [{'image_id': 'bcr-2020-239269f02', 'image_file_name': 'bcr-2020-239269f02.jpg', 'image_path': '../data/media_files/PMC7549461/bcr-2020-239269f02.jpg', 'caption': 'CT imaging of the brain demonstrating foci of hypoattenuation in the brain parenchyma.', 'hash': 'f25d1f31000e17b6b399605a20f9a22f20d13130c396cbc98ea2e9543d133147'}, {'image_id': 'bcr-2020-239269f05', 'image_file_name': 'bcr-2020-239269f05.jpg', 'image_path': '../data/media_files/PMC7549461/bcr-2020-239269f05.jpg', 'caption': 'Repeat CT imaging demonstrates resolution of hepatic abscesses, pleural effusions and airspace opacifications.', 'hash': 'c85cdab264feaa347cf015da20e035af5bae5c1dac034a47de3043a7b15a012e'}, {'image_id': 'bcr-2020-239269f04', 'image_file_name': 'bcr-2020-239269f04.jpg', 'image_path': '../data/media_files/PMC7549461/bcr-2020-239269f04.jpg', 'caption': 'CT angiogram images demonstrating a filling defect within the left internal jugular vein.', 'hash': '6bc19febf047fcdc50e87f360e2ff24278bea26e6230adac3215342620656318'}, {'image_id': 'bcr-2020-239269f03', 'image_file_name': 'bcr-2020-239269f03.jpg', 'image_path': '../data/media_files/PMC7549461/bcr-2020-239269f03.jpg', 'caption': 'MRI image revealing multifocal abscesses in both cerebral hemispheres.', 'hash': '41552f8bb6365b48c1a4d61597a0c52581ce88c756c1c33dd166f418f9d51326'}, {'image_id': 'bcr-2020-239269f01', 'image_file_name': 'bcr-2020-239269f01.jpg', 'image_path': '../data/media_files/PMC7549461/bcr-2020-239269f01.jpg', 'caption': 'CT images demonstrating multifocal hepatic lesions and dense airspace opacifications.', 'hash': 'e84ef1cf21d1b4a0f0d330b42513081bf7b5a8d2be49d38816a8dbe58adb1a53'}] | {'bcr-2020-239269f01': ['CT of the thorax, abdomen and pelvis revealed multifocal hepatic lesions consistent with disseminated hepatic abscesses and multiple foci throughout the lungs in keeping with septic emboli (<xref ref-type="fig" rid="bcr-2020-239269f01">figure 1</xref>).).'], 'bcr-2020-239269f02': ['CT of the brain demonstrated multiple foci of hypoattenuation in the brain parenchyma suspicious for cerebral abscesses (<xref ref-type="fig" rid="bcr-2020-239269f02">figure 2</xref>).).'], 'bcr-2020-239269f03': ['Transthoracic echocardiogram (TTE) showed no vegetation but a patent foramen ovale was noted. SARS-CoV-2 swab and blood-borne viral screening were negative, while MRI of the brain demonstrated multifocal abscesses in both cerebral hemispheres (<xref ref-type="fig" rid="bcr-2020-239269f03">figure 3</xref>). Initial CT angiogram of the neck revealed bilateral dental abscesses but no neck collection or abscess, and no filling defect within the vasculature. However, a subsequent CT angiogram during the course of the admission revealed a filling defect within the left internal jugular vein (). Initial CT angiogram of the neck revealed bilateral dental abscesses but no neck collection or abscess, and no filling defect within the vasculature. However, a subsequent CT angiogram during the course of the admission revealed a filling defect within the left internal jugular vein (<xref ref-type="fig" rid="bcr-2020-239269f04">figure 4</xref>). No further filling defects were identified within the surrounding vasculature, including the lingual and tonsillar veins.). No further filling defects were identified within the surrounding vasculature, including the lingual and tonsillar veins.'], 'bcr-2020-239269f05': ['After 3\u2009weeks in ICU and a further 2\u2009weeks of ward-based rehabilitation as an inpatient, our patient was afebrile, symptom-free and mobilising with one crutch. Repeat imaging demonstrated marked improvement in the hepatic abscesses. He was discharged home to continue intravenous ceftriaxone and oral metronidazole via the outpatient parenteral antimicrobial programme, with plans to continue his anticoagulant therapy for 3\u2009months. Follow-up was arranged through the infectious disease clinic and repeat imaging at a 4-week interval showed resolution of hepatic abscesses, resolution of pleural effusions and airspace opacifications (<xref ref-type="fig" rid="bcr-2020-239269f05">figure 5</xref>), with considerable reduction in intracranial abscesses.), with considerable reduction in intracranial abscesses.']} | Fusobacterium necrophorum Late presentation of ‘Lemierre’s syndrome’: how a delay in seeking healthcare and reduced access to routine services resulted in widely disseminated infection during the global COVID-19 pandemic | [
"infectious diseases",
"infection (neurology)",
"radiology",
"ear",
"nose and throat/otolaryngology",
"haematology (incl blood transfusion)"
] | BMJ Case Rep | 1602313200 | The aim of the current study was to assess the risk for post-partum depression among women delivering during the COVID-19 pandemic as compared to the risk among women delivering before the COVID-19 pandemic. A cohort study was performed among women delivering singletons at term which were recruited in the maternity wards of the Soroka University Medical Center. Recruitment was done during the COVID-19 strict isolation period (March 18 and April 29, 2020). Women delivering during the COVID-19 pandemic completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared to women delivering at the same medical center before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. A total of 223 women who delivered during the COVID-19 strict isolation period were recruited. Women delivering during the COVID-19 pandemic had lower risk of having a high (> 10) or very high (≥ 13) EPDS score as compared with women delivering before the COVID-19 pandemic (16.7% vs 31.3%, p = 0.002, and 6.8% vs 15.2%, p = 0.014, for EPDS ≥ 10 and EPDS ≥ 13, respectively). These results remained similar in the multivariable logistic regression models, for both EPDS score ≥ 10 and EPDS score ≥ 13, while controlling for maternal age, ethnicity, marital status, and adverse pregnancy outcomes (adjusted OR 0.4, 95% CI 0.23-0.70, p = 0.001 and adjusted OR 0.3, 95% CI 0.15-0.74, p = 0.007 for EPDS score > 10 and > 13, respectively). In our population, delivering during the COVID-19 pandemic was independently associated with lower risk of post-partum depression. | [
"Adult",
"COVID-19",
"Cohort Studies",
"Depression, Postpartum",
"Female",
"Humans",
"Israel",
"Pandemics",
"Postpartum Period",
"Pregnancy",
"Psychiatric Status Rating Scales",
"Quarantine",
"Risk Factors",
"SARS-CoV-2",
"Young Adult"
] | other | PMC7549461 | null | 35 | [
"{'Citation': 'Abu-Ganem S, Sheiner E, Sherf M, Wiznitzer A, Sergienko R, Shoham-Vardi I. Lack of prenatal care in a traditional community: trends and perinatal outcome. Arch Gynecol Obstet. 2012;285(5):1237–1242. doi: 10.1007/s00404-011-2153-x.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00404-011-2153-x'}, {'@IdType': 'pubmed', '#text': '22124534'}]}}",
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] | BMJ Case Rep. 2020 Oct 10; 13(10):e239269 | NO-CC CODE |
|
Computed tomography of the chest on emergency department admission at the referring hospital. | gr2_lrg | 7 | 8e87834163add8be94876135c02cfe7e2a9224343eb9a1932aa01757ca3b8854 | gr2_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
708,
240
] | [{'image_id': 'gr3_lrg', 'image_file_name': 'gr3_lrg.jpg', 'image_path': '../data/media_files/PMC7836635/gr3_lrg.jpg', 'caption': 'Chest X-ray at V–V ECMO initiation.', 'hash': 'a4c4d8a0275b6f3bd0367aa560e47d2e69099865ae6cf0b7b084bf4b16ed0e37'}, {'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC7836635/gr2_lrg.jpg', 'caption': 'Computed tomography of the chest on emergency department admission at the referring hospital.', 'hash': '8e87834163add8be94876135c02cfe7e2a9224343eb9a1932aa01757ca3b8854'}, {'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC7836635/gr1_lrg.jpg', 'caption': 'Chest X-ray on emergency department admission at the referring hospital.', 'hash': '3576ef2f51877fc02c0f08fb13ca8e1d02908ddf381d1c5bef9b3908bd021a71'}] | {'gr1_lrg': ['He was admitted to a hospital approximately 40\xa0km away from our hospital (Supplemental Table 1). Chest x-ray revealed consolidation with air bronchograms in the left and right lower lobes, indicating multifocal pneumonia (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, , <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>\n). After admission, the patient complained of shortness of breath, and his oxygen saturation gradually decreased. On day 10 of hospitalization, invasive mechanical ventilation was initiated owing to low blood oxygen saturation with a PO\n). After admission, the patient complained of shortness of breath, and his oxygen saturation gradually decreased. On day 10 of hospitalization, invasive mechanical ventilation was initiated owing to low blood oxygen saturation with a PO2/FIO2 ratio of 60 (mechanical ventilator settings: BIPAP, FIO2, 1.0; PEEP, 12 cmH2O; inspiratory pressure, 22 cmH2O; ventilation rate, 28/min) (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>\n).\n).Fig. 1Chest X-ray on emergency department admission at the referring hospital.Fig. 1Fig. 2Computed tomography of the chest on emergency department admission at the referring hospital.Fig. 2Fig. 3Chest X-ray at V–V ECMO initiation.Fig. 3']} | Interhospital transportation of a COVID-19 patient undergoing veno-venous extracorporeal membrane oxygenation by helicopter | null | Am J Emerg Med | 1620025200 | The COVID-19 pandemic put global medical systems under massive pressure for its uncertainty, severity, and persistence. For detecting the prevalence of suicidal and self-harm ideation (SSI) and its related risk factors among hospital staff during the COVID-19 pandemic, this cross-sectional study collected the sociodemographic data, epidemic-related information, the psychological status and need, and perceived stress and support from 11507 staff in 46 hospitals by an online survey from February 14 to March 2, 2020. The prevalence of SSI was 6.47%. Hospital staff with SSI had high family members or relatives infected number and the self-rated probability of infection. Additionally, they had more perceived stress, psychological need, and psychological impact. On the contrary, hospital staff without SSI reported high self-rated health, willingness to work in a COVID-19 ward, confidence in defeating COVID-19, and perceived support. Furthermore, they reported better marital or family relationship, longer sleep hours, and shorter work hours. The infection of family members or relatives, poor marital status, poor self-rated health, the current need for psychological intervention, perceived high stress, perceived low support, depression, and anxiety were independent factors to SSI. A systematic psychological intervention strategy during a public health crisis was needed for the hospital staff's mental well-being. | [
"Adult",
"Anxiety Disorders",
"Asian People",
"COVID-19",
"China",
"Cross-Sectional Studies",
"Depressive Disorder",
"Female",
"Humans",
"Incidence",
"Male",
"Personnel, Hospital",
"Self-Injurious Behavior",
"Suicidal Ideation",
"Uncertainty",
"Young Adult"
] | other | PMC7836635 | null | 40 | [
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] | Am J Emerg Med. 2021 May 3; 43:290.e5-290.e7 | NO-CC CODE |
|
T2 fat sat coronal (A) and corresponding coronal CT image (B) showing hyperintense signal with air pockets along the sciatic nerve (arrows) extending from the pelvis to the thigh. In CT image (B), the arrowhead marks the thickened edematous right levator ani muscle and the asterix (*) marks the ischiorectal fossa abscess. | poljradiol-81-370-g004 | 7 | 48e1c5a5ddef98bdafa6cd5641a518d9caaf1cce728e665d1a5b97fcfd320901 | poljradiol-81-370-g004.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
820
] | [{'image_id': 'poljradiol-81-370-g001', 'image_file_name': 'poljradiol-81-370-g001.jpg', 'image_path': '../data/media_files/PMC5036378/poljradiol-81-370-g001.jpg', 'caption': 'STIR coronal image showing hyperintense signal on the right side of the pelvis (arrow) which is seen extending towards the greater sciatic foramen (arrow heads).', 'hash': '75bc763e9ee544361c99b7ccb2394c80a8b7eea1431a45a5bdc848ccbba729db'}, {'image_id': 'poljradiol-81-370-g004', 'image_file_name': 'poljradiol-81-370-g004.jpg', 'image_path': '../data/media_files/PMC5036378/poljradiol-81-370-g004.jpg', 'caption': 'T2 fat sat coronal (A) and corresponding coronal CT image (B) showing hyperintense signal with air pockets along the sciatic nerve (arrows) extending from the pelvis to the thigh. In CT image (B), the arrowhead marks the thickened edematous right levator ani muscle and the asterix (*) marks the ischiorectal fossa abscess.', 'hash': '48e1c5a5ddef98bdafa6cd5641a518d9caaf1cce728e665d1a5b97fcfd320901'}, {'image_id': 'poljradiol-81-370-g003', 'image_file_name': 'poljradiol-81-370-g003.jpg', 'image_path': '../data/media_files/PMC5036378/poljradiol-81-370-g003.jpg', 'caption': 'Diffusion weighted image (A) and a corresponding ADC image (B) showing restriction of diffusion in the abscess cavity (arrows).', 'hash': '5837a4179fd5ef8d2c6d4e55fd344a9bf6799f5f7f211d80c8d341e2b14581e1'}, {'image_id': 'poljradiol-81-370-g002', 'image_file_name': 'poljradiol-81-370-g002.jpg', 'image_path': '../data/media_files/PMC5036378/poljradiol-81-370-g002.jpg', 'caption': 'T1WI (A) shows a hypointense lesion in the right ischiorectal fossa region (arrow). T2W Fat sat image (B) shows hyperintense signal in the right ischiorectal fossa region with hyperintense signal extending towards the greater sciatic foramen and along the sciatic nerve (arrow head). Multiple tiny hypointense foci seen in both the T1 and T2W fat sat images representing air as confirmed by corresponding axial CT images (C, D). Tiny pockets of air are also seen along the sciatic nerve (C, D).', 'hash': 'a6e7cd310975d303cd60a2ef7196d1706f38a3633f4f5e83a78a25727ee8b609'}] | {'poljradiol-81-370-g001': ['MRI of the lumbosacral spine was advised for evaluation of the back pain radiating to the right limb. MRI of the lumbosacral spine did not reveal any significant spinal abnormality. However, an abnormal hyperintense signal was noticed in the right gluteal muscles and perianal region on large field of view STIR coronal images (<xref ref-type="fig" rid="poljradiol-81-370-g001">Figure 1</xref>). Subsequently, dedicated T2W and T1W images were taken for assessment of the pelvis. A perianal collection with marked T2WI and T1WI hypointensities suggestive of air was noticed (). Subsequently, dedicated T2W and T1W images were taken for assessment of the pelvis. A perianal collection with marked T2WI and T1WI hypointensities suggestive of air was noticed (<xref ref-type="fig" rid="poljradiol-81-370-g002">Figure 2</xref>). Abnormal STIR hyperintense signals with air pockets were also noted extending into the right greater sciatic notch and along the right sciatic nerve. Additionally, the diffusion weighted sequence was planned and it revealed areas of restriction within the right perianal collection (). Abnormal STIR hyperintense signals with air pockets were also noted extending into the right greater sciatic notch and along the right sciatic nerve. Additionally, the diffusion weighted sequence was planned and it revealed areas of restriction within the right perianal collection (<xref ref-type="fig" rid="poljradiol-81-370-g003">Figure 3</xref>). A CT scan of the pelvis confirmed presence of perianal abscess in the right ischiorectal fossa with multiple air pockets (). A CT scan of the pelvis confirmed presence of perianal abscess in the right ischiorectal fossa with multiple air pockets (<xref ref-type="fig" rid="poljradiol-81-370-g002">Figures 2</xref>, , <xref ref-type="fig" rid="poljradiol-81-370-g004">4</xref>), tracking along the right sciatic nerve up to the mid-thigh. Preoperative evaluation of the patient also revealed high fasting (165 mg/dL) and postprandial (220 mg/dL) blood glucose levels. The right ischiorectal fossa abscess was surgically drained with a drainage tube kept in the ischiorectal fossa. Microbiological examination of the abscess revealed gram-negative rods suggesting Escherichia coli. A postoperative CT scan 3 days later revealed significant resolution of the abscess and the air pockets. The patient was discharged after 3 days of hospitalization on oral antibiotic treatment for gram-negative and anaerobic bacteria for 7 days. On 15), tracking along the right sciatic nerve up to the mid-thigh. Preoperative evaluation of the patient also revealed high fasting (165 mg/dL) and postprandial (220 mg/dL) blood glucose levels. The right ischiorectal fossa abscess was surgically drained with a drainage tube kept in the ischiorectal fossa. Microbiological examination of the abscess revealed gram-negative rods suggesting Escherichia coli. A postoperative CT scan 3 days later revealed significant resolution of the abscess and the air pockets. The patient was discharged after 3 days of hospitalization on oral antibiotic treatment for gram-negative and anaerobic bacteria for 7 days. On 15th post-operative day, the patient was completely asymptomatic and showed signs of healthy healing of the perianal surgical wound.']} | Sciatica: An Extremely Rare Complication of the Perianal Abscess | [
"Magnetic Resonance Imaging",
"Perianal Glands",
"Sciatica"
] | Pol J Radiol | 1470466800 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'Sciatica has been classically described as pain in the back and hip with radiation in the leg along the distribution of the sciatic nerve, secondary to compression or irritation of the sciatic nerve. Spinal abnormality being the most common etiology, is one of the most common indications for MRI of the lumbosacral spine. Here we describe imaging findings secondary to a supralevator perianal abscess causing irritation of the sciatic nerve, which was diagnosed on MRI of the lumbosacral spine.'}, {'@Label': 'CASE REPORT', '@NlmCategory': 'METHODS', 'sup': 'th', '#text': 'A 47-year-old male patient presented to the emergency department with severe acute pain in the right hip and right leg which was aggravated by limb movement. Clinically, a possibility of sciatica was suggested and MRI of the lumbosacral spine was ordered. The MRI did not reveal any abnormality in the lumbosacral spine; however, on STIR coronal images, a right perianal abscess with air pockets was seen. The perianal abscess was extending above the levator ani muscle with and was seen tracking along the sciatic nerve, explaining pain along the distribution of the sciatic nerve. The abscess was surgically drained, followed by an antibiotic course. The patient was symptomatically better post-surgery. Post-operative scan done 3 days later revealed significant resolution of the infra- and supralevator perianal abscess. The patient was discharged from hospital on post-operative day 3 on oral antibiotics for 7 days. On 15 post-operative day, the patient was clinically completely asymptomatic with good healing of the perianal surgical wound.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'Extra-spinal causes are rare and most often overlooked in patients with sciatica. While assessing patients with sciatica, extra-spinal causes for the radiation of pain along the distribution of the sciatic nerve should always be looked for if abnormalities in the MRI of the lumbar spine are not found. Inclusion of STIR sequences in the imaging of the lumbosacral spine, more often than not, helps to identify the extra-spinal cause of sciatica when MRI of the lumbosacral spine does not reveal any abnormality.'}] | [] | other | PMC5036378 | null | 16 | [
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] | Pol J Radiol. 2016 Aug 6; 81:370-373 | NO-CC CODE |
|
Computed tomography (CT), coronal section, shows a fatty oval lesion measuring 12 mm in diameter with a circumferential hyperdense ring in the right lower abdomen. | medscimonit-17-10-CS113-g001 | 7 | 3d14fe927473efcf9dd7df32447fd7684acb886ecf58a094b84c3c9d920b2886 | medscimonit-17-10-CS113-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
603
] | [{'image_id': 'medscimonit-17-10-CS113-g001', 'image_file_name': 'medscimonit-17-10-CS113-g001.jpg', 'image_path': '../data/media_files/PMC3539461/medscimonit-17-10-CS113-g001.jpg', 'caption': 'Computed tomography (CT), coronal section, shows a fatty oval lesion measuring 12 mm in diameter with a circumferential hyperdense ring in the right lower abdomen.', 'hash': '3d14fe927473efcf9dd7df32447fd7684acb886ecf58a094b84c3c9d920b2886'}, {'image_id': 'medscimonit-17-10-CS113-g002', 'image_file_name': 'medscimonit-17-10-CS113-g002.jpg', 'image_path': '../data/media_files/PMC3539461/medscimonit-17-10-CS113-g002.jpg', 'caption': 'The transverse CT image shows that the ovoid pericolonic mass abuts on the ascending colon and is surrounded by ill-defined fat stranding.', 'hash': 'a6cf9835acf3bb5dd664f7482acd6b73b359ed08b6877b9405740eb8aed5bef9'}, {'image_id': 'medscimonit-17-10-CS113-g003', 'image_file_name': 'medscimonit-17-10-CS113-g003.jpg', 'image_path': '../data/media_files/PMC3539461/medscimonit-17-10-CS113-g003.jpg', 'caption': 'Thickening of the parietal peritoneum is seen.', 'hash': '24374f8c021a23fecc939ba7aba0b988c37dc9cce8278a69becd71b79e626b64'}] | {'medscimonit-17-10-CS113-g001': ['A healthy 27-year-old man was admitted to our hospital due to acute right lower quadrant abdominal pain. He denied nausea, vomiting, or diarrhea. On physical examination, the blood pressure was 111/64 mmHg, the heart rate was 75 beats per minute and regular, the respiratory rate was 16 breaths per minute, and the temperature was 37.9°C. Abdominal examination showed focal abdominal tenderness with slight rebound tenderness. Bowel sounds were normal, and no tumor was palpable. Laboratory tests showed a white blood cell count of 9000/mm3 (3900/mm3 to 8900/mm3) and a CRP of 8.7 mg/dL (<0.17 mg/dL). Otherwise, the laboratory data were within normal limits. The patient was treated with cefmetazole sodium (2 g/day) for 2 days, but the symptoms became worse. The antimicrobial dose was increased to 4 g/day for the subsequent 3 days. An abdominal series and ultrasound of the upper abdomen were performed and interpreted as normal. On the coronal section of computed tomography (CT), a fatty oval lesion measuring 12 mm in diameter with a circumferential hyperdense ring (arrow, <xref ref-type="fig" rid="medscimonit-17-10-CS113-g001">Figure 1</xref>) was seen in the right lower abdomen. The transverse CT image showed that the ovoid, pericolonic mass abutted on the ascending colon and was surrounded by ill-defined fat stranding (arrow, ) was seen in the right lower abdomen. The transverse CT image showed that the ovoid, pericolonic mass abutted on the ascending colon and was surrounded by ill-defined fat stranding (arrow, <xref ref-type="fig" rid="medscimonit-17-10-CS113-g002">Figure 2</xref>). Thickening of the parietal peritoneum was seen (arrow heads, ). Thickening of the parietal peritoneum was seen (arrow heads, <xref ref-type="fig" rid="medscimonit-17-10-CS113-g003">Figure 3</xref>). There was neither free air nor ascites, and the appendix was normal. These findings were diagnostic of primary epiploic appendagitis. Antibiotics were discontinued. Oral loxoprofen sodium (60 mg) was prescribed twice before his symptoms and signs resolved with normalization of the laboratory results. The patient was doing well at the last outpatient follow-up visit.). There was neither free air nor ascites, and the appendix was normal. These findings were diagnostic of primary epiploic appendagitis. Antibiotics were discontinued. Oral loxoprofen sodium (60 mg) was prescribed twice before his symptoms and signs resolved with normalization of the laboratory results. The patient was doing well at the last outpatient follow-up visit.']} | Epiploic appendagitis in a 27-year-old man | [
"epiploic appendagitis",
"computed tomography",
"epiploic appendage"
] | Med Sci Monit | 1317452400 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'The aim of this study was to screen molecular biomarkers for biodosimetry from DNA repair-related gene expression profiles.'}, {'@Label': 'MATERIAL/METHODS', '@NlmCategory': 'METHODS', '#text': 'Mice were subjected to whole-body exposure with 60Co gamma rays with a dose range of 0-8 Gy at a dose rate of 0.80 Gy/min. RNA was extracted from the peripheral blood of irradiated mice at 4, 8, 12, 24 and 48hrs post-irradiation. The mRNA transcriptional changes of 11 genes related to DNA damage and repair were detected using real-time quantitative polymerase chain reaction (RT-PCR).'}, {'@Label': 'RESULTS', '@NlmCategory': 'RESULTS', '#text': 'Of the 11 genes examined, CDKN1A (cyclin-dependent kinase inhibitor 1A or p21, Cip1) and ATM (ataxia telangiectasia mutated) expression levels were found to be heavily up- and down-regulated, respectively, with exposure dose increasing at different post-irradiation times. RAD50 (RAD50 homolog), PLK3 (polo-like kinase 3), GADD45A (growth arrest and DNA damage-inducible, alpha), DDB2 (damage-specific DNA-binding protein 2), BBC3 (BCL2-binding component 3) and IER5 (immediate early response 5) gene expression levels were found to undergo significant oscillating changes over a broad dose range of 2-8 Gy at post-exposure time points observed. Three of the genes were found not to change within the observed exposure dose and post-radiation time ranges.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'The results of this study add to the biodosimetry with biomarker data pool and will be helpful for constructing appropriate gene expression biomarker systems to evaluate radiation exposure doses.'}] | [
"Animals",
"Ataxia Telangiectasia Mutated Proteins",
"Cell Cycle Proteins",
"Cobalt Radioisotopes",
"Cyclin-Dependent Kinase Inhibitor p21",
"DNA Repair",
"DNA-Binding Proteins",
"Dose-Response Relationship, Radiation",
"Gamma Rays",
"Gene Expression Regulation",
"Leukocytes",
"Male",
"Mice",
"Mice, Inbred BALB C",
"Protein Serine-Threonine Kinases",
"Radiometry",
"Real-Time Polymerase Chain Reaction",
"Tumor Suppressor Proteins"
] | other | PMC3539461 | null | 45 | [
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] | Med Sci Monit. 2011 Oct 1; 17(10):CS113-CS115 | NO-CC CODE |
|
Chest CT images of Case 2 patient during hospitalization: A) Day 3 of his illness, ground-glass opacity on both lower lobes and right middle lobe and lingual. B) Day 7 of his illness, ground-glass opacity extended and new consolidation appeared. C) Day 13 of his illness. ground glass opacity and consolidation almost diminished. | gr3_lrg | 7 | a6120df2485b4c70d793c6ab2b3d304b94c7810690ede43238d60baf383bc6ec | gr3_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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] | [{'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC7366999/gr2_lrg.jpg', 'caption': 'Chest CT images of Case 1 patient during hospitalization: A) Day 8 of his illness, peripheral ground-glass opacity and consolidation on both lower lobes. B) Day 11 of his illness, consolidation on the dorsal side increased in extent. C) Day 17 of his illness, consolidation on dorsal side tend to disappear, however new ground glass opacity appeared on right middle lobe and left S8.', 'hash': 'ee165d0c98849054cd0a71e3cdfdc9f5670e2fd35612ad9e25b2f8aeee2c4033'}, {'image_id': 'gr3_lrg', 'image_file_name': 'gr3_lrg.jpg', 'image_path': '../data/media_files/PMC7366999/gr3_lrg.jpg', 'caption': 'Chest CT images of Case 2 patient during hospitalization: A) Day 3 of his illness, ground-glass opacity on both lower lobes and right middle lobe and lingual. B) Day 7 of his illness, ground-glass opacity extended and new consolidation appeared. C) Day 13 of his illness. ground glass opacity and consolidation almost diminished.', 'hash': 'a6120df2485b4c70d793c6ab2b3d304b94c7810690ede43238d60baf383bc6ec'}, {'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC7366999/gr1_lrg.jpg', 'caption': 'Clinical courses of 2 case-patients with COVID-19. (A) Case 1 patient, 42-year-old male. (B) Case 2 patient, 78-year-old male. Body temperature is maximum body temperature in a day; AC, Acetaminophen; Oro, oropharyngeal swabs; RT-PCR, reverse transcription PCR.', 'hash': '381359447d7bdc96a2f9d6918ccf178e5cdb7f89b159f2137e68628891f9dfc7'}] | {'gr1_lrg': ['Case 1: A 42-year-old man with no underlying medical conditions was admitted to our hospital after being diagnosed with COVID-19 by RT-PCR assay of an oropharyngeal swab sample performed 2 days earlier. Five days before admission, he had noticed fever, dry cough and arthralgia (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>\n-A). On admission (day 6 of illness), he was febrile (37.6\xa0°C), blood pressure was 130/68\xa0mmHg, and respiratory rate was 20 breaths/min. Oxygen saturation was 94% on room air. Computed tomography (CT) revealed consolidation and ground glass opacity in both lower lobes (\n-A). On admission (day 6 of illness), he was febrile (37.6\xa0°C), blood pressure was 130/68\xa0mmHg, and respiratory rate was 20 breaths/min. Oxygen saturation was 94% on room air. Computed tomography (CT) revealed consolidation and ground glass opacity in both lower lobes (<xref rid="gr2_lrg" ref-type="fig">Fig.\xa02</xref>\n).\n).Fig.\xa01Clinical courses of 2 case-patients with COVID-19. (A) Case 1 patient, 42-year-old male. (B) Case 2 patient, 78-year-old male. Body temperature is maximum body temperature in a day; AC, Acetaminophen; Oro, oropharyngeal swabs; RT-PCR, reverse transcription PCR.Fig.\xa01Fig.\xa02Chest CT images of Case 1 patient during hospitalization: A) Day 8 of his illness, peripheral ground-glass opacity and consolidation on both lower lobes. B) Day 11 of his illness, consolidation on the dorsal side increased in extent. C) Day 17 of his illness, consolidation on dorsal side tend to disappear, however new ground glass opacity appeared on right middle lobe and left S8.Fig.\xa02', 'On day 9 of his illness, oxygen saturation could not be maintained under nasal oxygen therapy, so high-flow nasal oxygen therapy was started at 40L/min and 40%, (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-A). The RT-PCR result became negative on day 13 (-A). The RT-PCR result became negative on day 13 (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-A), after which respiratory status improved and fever decreased. He was discharged on day 20 after confirming 2 consecutive negative RT-PCR results from oropharyngeal swab samples (-A), after which respiratory status improved and fever decreased. He was discharged on day 20 after confirming 2 consecutive negative RT-PCR results from oropharyngeal swab samples (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-A), in line with the criteria for discharge in Japan. Chest CT findings gradually improved following the seroconversion of viral RNA to negative and improvement of general condition (-A), in line with the criteria for discharge in Japan. Chest CT findings gradually improved following the seroconversion of viral RNA to negative and improvement of general condition (<xref rid="gr2_lrg" ref-type="fig">Fig.\xa02</xref>). During hospitalization, we did not administer any antiviral or steroid therapy but provided only conservative and supportive care such as administering antipyretics and implementing measures to deep vein thrombosis. No symptoms suspect for recurrence of COVID-19 have been detected since discharge.). During hospitalization, we did not administer any antiviral or steroid therapy but provided only conservative and supportive care such as administering antipyretics and implementing measures to deep vein thrombosis. No symptoms suspect for recurrence of COVID-19 have been detected since discharge.', 'Case 2: A 78-year-old man with chronic heart failure by old myocardial infarction and hypertension was admitted to our hospital after being diagnosed with COVID-19. Two days before admission, he had noticed fatigue. On admission (day 3 of his illness), he was febrile (38.0\xa0°C) and had a dry cough (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-B). Blood pressure was 120/70\xa0mmHg, respiratory rate was 24 breaths/min and oxygen saturation level was around 93% on room air. Chest CT showed ground glass opacity in both lower lung lobes (-B). Blood pressure was 120/70\xa0mmHg, respiratory rate was 24 breaths/min and oxygen saturation level was around 93% on room air. Chest CT showed ground glass opacity in both lower lung lobes (<xref rid="gr3_lrg" ref-type="fig">Fig.\xa03</xref>\n). Respiratory condition deteriorated and his body temperature increased to 38.8\xa0°C on day 6 of his illness. RT-PCR for SARS-CoV-2 RNA was performed using a serum sample and the result was found to be positive. We then retrospectively performed RT-PCR of a serum sample that had been collected on admission (day 3 of illness) from the patient and found PCR assay was positive. Subsequently, RT-PCR of serum SARS-CoV-2 RNA was performed prospectively.\n). Respiratory condition deteriorated and his body temperature increased to 38.8\xa0°C on day 6 of his illness. RT-PCR for SARS-CoV-2 RNA was performed using a serum sample and the result was found to be positive. We then retrospectively performed RT-PCR of a serum sample that had been collected on admission (day 3 of illness) from the patient and found PCR assay was positive. Subsequently, RT-PCR of serum SARS-CoV-2 RNA was performed prospectively.Fig.\xa03Chest CT images of Case 2 patient during hospitalization: A) Day 3 of his illness, ground-glass opacity on both lower lobes and right middle lobe and lingual. B) Day 7 of his illness, ground-glass opacity extended and new consolidation appeared. C) Day 13 of his illness. ground glass opacity and consolidation almost diminished.Fig.\xa03', 'On day 7 of illness, respiratory failure progressed and oxygen saturation concentration could not be maintained on nasal oxygen therapy, so we started high-flow nasal oxygen therapy at 40 L and 40%. The RT-PCR result became negative on day 9 (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-B), following which respiratory status improved and fever decreased.-B), following which respiratory status improved and fever decreased.', 'We found that the RT-PCR result became negative on day 9 in Case 2 (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-B). Chest CT findings also gradually improved (-B). Chest CT findings also gradually improved (<xref rid="gr3_lrg" ref-type="fig">Fig.\xa03</xref>). After we confirmed 2 consecutive negative RT-PCR results from oropharyngeal swab samples, he was discharged on day 22 (). After we confirmed 2 consecutive negative RT-PCR results from oropharyngeal swab samples, he was discharged on day 22 (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>-B). During hospitalization, we did not administer any antiviral or steroid therapy. He has had no symptoms suspect for recurrence of COVID-19 after discharge.-B). During hospitalization, we did not administer any antiviral or steroid therapy. He has had no symptoms suspect for recurrence of COVID-19 after discharge.']} | Serial serum SARS-CoV-2 RNA results in two COVID-19 cases with severe respiratory failure | [
"COVID-19",
"Severe respiratory failure",
"Serum SARS-CoV-2 RNA"
] | J Infect Chemother | 1605600000 | [] | other | PMC7366999 | null | 3 | [
"{'Citation': 'Sandars J, Correia R, Dankbaar M, de Jong P, Goh P, Hege I, Masters K, Oh S, Patel R, Premkumar K, Webb A, Pusic M. Twelve tips for rapidly migrating to online learning during the COVID-19 pandemic. MedEdPublish 10.15694/mep.2020.000082.1, 2020', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC10697562'}, {'@IdType': 'pubmed', '#text': '38058947'}]}}",
"{'Citation': 'Hodges CB, Moore S, Lockee BB, Trust T, Bond MA. The difference between emergency remote teaching and online learning. EducauseReview. March 27, 2020. https://er.educause.edu/articles/2020/3/the-difference-between-emergency-remote-teaching-and-online-learning'}",
"{'Citation': 'Puentedura, RR (2013). SAMR: Moving from enhancement to transformation [Web log post]. Retrieved from http://www.hippasus.com/rrpweblog/archives/000095.html'}"
] | J Infect Chemother. 2020 Nov 17; 26(11):1220-1223 | NO-CC CODE |
||
Chest Imaging Studies Obtained on Admission.A radiograph (Panel A) shows patchy opacities with rounded contours in the peripheral left upper lobe (arrow) and perihilar patchy opacities (arrowheads), along with evidence of mild cardiomegaly. Axial (Panels B and C) and coronal (Panel D) CT pulmonary angiographic images show multifocal consolidative opacities (arrows) and ground-glass opacities (arrowheads), including some with rounded morphologic features, in both lungs. The distribution of these findings is predominantly peripheral and peribronchial. | NEJMcpc2004974_f1 | 7 | ff99bb47fed61e7490ec37b9b93246d175eceaf95c5e82d859549f35f3120feb | NEJMcpc2004974_f1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
548
] | [{'image_id': 'NEJMcpc2004974_f2', 'image_file_name': 'NEJMcpc2004974_f2.jpg', 'image_path': '../data/media_files/PMC7367503/NEJMcpc2004974_f2.jpg', 'caption': 'Lung Autopsy Specimens.On hematoxylin and eosin staining, both lungs show architecturally preserved alveolar parenchyma (Panel A) with thick hyaline membranes (Panel B, asterisks) associated with pneumocyte denudation (Panel C, arrows). In some areas, alveolar walls show increased cellularity with some spindled fibroblast-like cells (Panel C, asterisk). These findings are consistent with an exudative to early proliferative phase of diffuse alveolar damage. There are also rare foci with neutrophilic and histiocytic infiltrates in alveolar spaces (Panel D), features suggestive of a focal pneumonic process. Immunohistochemical staining for SARS nucleocapsid protein highlights scattered pneumocytes (Panel E, arrow) and alveolar macrophages, findings supportive of a diagnosis of SARS-CoV-2 infection in the lungs. Thick mucin and epithelial denudation are seen in the majority of bronchi, and squamous metaplasia with reactive changes is focally replacing the denuded lining (Panel F). Only a few scattered perivascular chronic inflammatory aggregates (Panel G, arrowheads) and rare fibrin thrombi in small pulmonary arteries (Panel H) are present in this case.', 'hash': 'f9503cea8aa1e7f72e08b8d70a1ed4bb07e3547f43257c742976254b81750f94'}, {'image_id': 'NEJMcpc2004974_t1', 'image_file_name': 'NEJMcpc2004974_t1.jpg', 'image_path': '../data/media_files/PMC7367503/NEJMcpc2004974_t1.jpg', 'caption': 'No caption found', 'hash': 'a9ba0b79c5c50098159bedf6c5b6f5f065763d396eecfb6f5cc71e7ca75b977e'}, {'image_id': 'NEJMcpc2004974_f3', 'image_file_name': 'NEJMcpc2004974_f3.jpg', 'image_path': '../data/media_files/PMC7367503/NEJMcpc2004974_f3.jpg', 'caption': 'Heart Autopsy Specimens.On hematoxylin and eosin staining, there is increased infiltration of the myocardium by macrophages (Panel A, arrowheads); on immunohistochemical staining, the macrophages express the marker CD68 (Panel B, in brown). There is also focal infiltration of the myocardium by lymphocytes (Panel C, arrowheads), which express the marker CD3 (Panel D, in brown). These findings are not associated with myocyte injury.', 'hash': '013225f0ba66b01bb226be84938104fca80de9e9944ec513bf5343f6f3ef745c'}, {'image_id': 'NEJMcpc2004974_f1', 'image_file_name': 'NEJMcpc2004974_f1.jpg', 'image_path': '../data/media_files/PMC7367503/NEJMcpc2004974_f1.jpg', 'caption': 'Chest Imaging Studies Obtained on Admission.A radiograph (Panel A) shows patchy opacities with rounded contours in the peripheral left upper lobe (arrow) and perihilar patchy opacities (arrowheads), along with evidence of mild cardiomegaly. Axial (Panels B and C) and coronal (Panel D) CT pulmonary angiographic images show multifocal consolidative opacities (arrows) and ground-glass opacities (arrowheads), including some with rounded morphologic features, in both lungs. The distribution of these findings is predominantly peripheral and peribronchial.', 'hash': 'ff99bb47fed61e7490ec37b9b93246d175eceaf95c5e82d859549f35f3120feb'}] | {'NEJMcpc2004974_f1': ['Dr. John Conklin: On radiography of the chest (<xref rid="NEJMcpc2004974_f1" ref-type="fig">Figure 1A</xref>), patchy airspace opacities were present in the left upper lobe and surrounding the hilum. On computed tomographic (CT) pulmonary angiography of the chest (), patchy airspace opacities were present in the left upper lobe and surrounding the hilum. On computed tomographic (CT) pulmonary angiography of the chest (<xref rid="NEJMcpc2004974_f1" ref-type="fig">Figure 1B, 1C, and 1D</xref>), performed after the administration of intravenous contrast material, multifocal consolidative and ground-glass opacities, including some with rounded morphologic features, were present in both lungs. These findings have been commonly reported with Covid-19 pneumonia, although other processes, such as influenza pneumonia and organizing pneumonia, may have a similar appearance on imaging.), performed after the administration of intravenous contrast material, multifocal consolidative and ground-glass opacities, including some with rounded morphologic features, were present in both lungs. These findings have been commonly reported with Covid-19 pneumonia, although other processes, such as influenza pneumonia and organizing pneumonia, may have a similar appearance on imaging.1 There was no evidence of pulmonary embolism.'], 'NEJMcpc2004974_f2': ['Dr. Mari Mino-Kenudson: Microscopic examination of the lungs showed a broad area of architecturally preserved alveolar parenchyma with thick hyaline membranes associated with focal epithelial denudation and capillary congestion (<xref rid="NEJMcpc2004974_f2" ref-type="fig">Figure 2A, 2B, and 2C</xref>). In some areas, alveolar walls showed increased cellularity with some spindled fibroblast-like cells (). In some areas, alveolar walls showed increased cellularity with some spindled fibroblast-like cells (<xref rid="NEJMcpc2004974_f2" ref-type="fig">Figure 2C</xref>). These findings are consistent with an exudative to early proliferative phase of diffuse alveolar damage. In addition, there were rare foci with neutrophilic infiltrate along with histiocytes in alveolar spaces, features suggestive of a focal pneumonic process (). These findings are consistent with an exudative to early proliferative phase of diffuse alveolar damage. In addition, there were rare foci with neutrophilic infiltrate along with histiocytes in alveolar spaces, features suggestive of a focal pneumonic process (<xref rid="NEJMcpc2004974_f2" ref-type="fig">Figure 2D</xref>). There were no definitive viral cytopathic changes in the examined sections; however, rare multinucleated giant cells were identified, and immunohistochemical staining for SARS nucleocapsid protein (shared by SARS-CoV-1 and SARS-CoV-2) highlighted scattered pneumocytes and alveolar macrophages, findings supportive of a diagnosis of SARS-CoV-2 infection in the lungs (). There were no definitive viral cytopathic changes in the examined sections; however, rare multinucleated giant cells were identified, and immunohistochemical staining for SARS nucleocapsid protein (shared by SARS-CoV-1 and SARS-CoV-2) highlighted scattered pneumocytes and alveolar macrophages, findings supportive of a diagnosis of SARS-CoV-2 infection in the lungs (<xref rid="NEJMcpc2004974_f2" ref-type="fig">Figure 2E</xref>).).', 'In the airways, thick mucin and epithelial denudation were seen in the majority of bronchi, and squamous metaplasia with reactive changes focally replaced the residual epithelial lining (<xref rid="NEJMcpc2004974_f2" ref-type="fig">Figure 2F</xref>). These features, along with the aforementioned focal pneumonic process, are consistent with superimposed bronchopneumonia. A few scattered perivascular chronic inflammatory aggregates were present, but pathologically significant inflammation was not present and fibrin thrombi were rare in this case (). These features, along with the aforementioned focal pneumonic process, are consistent with superimposed bronchopneumonia. A few scattered perivascular chronic inflammatory aggregates were present, but pathologically significant inflammation was not present and fibrin thrombi were rare in this case (<xref rid="NEJMcpc2004974_f2" ref-type="fig">Figure 2G and 2H</xref>).).'], 'NEJMcpc2004974_f3': ['Dr. Stone: In the myocardium, there was relatively diffuse infiltration by CD68+ macrophages (<xref rid="NEJMcpc2004974_f3" ref-type="fig">Figure 3A</xref>), which was not associated with myocyte injury. Such infiltration of the myocardium by macrophages is not entirely specific but has been reported in patients with SARS-CoV-1 infection and has been associated with the presence of virus in the myocardium.), which was not associated with myocyte injury. Such infiltration of the myocardium by macrophages is not entirely specific but has been reported in patients with SARS-CoV-1 infection and has been associated with the presence of virus in the myocardium.10 In this case, there was also focal infiltration of the myocardium by CD3+ T lymphocytes (<xref rid="NEJMcpc2004974_f3" ref-type="fig">Figure 3B</xref>), which was not associated with myocyte injury and thus did not meet full criteria for myocarditis.), which was not associated with myocyte injury and thus did not meet full criteria for myocarditis.11 This degree of myocardial lymphocytic infiltrate was not described in a few recent case reports with autopsy and endomyocardial biopsy results from patients with Covid-19,12-17 but many of those cases involved only limited sampling of the heart. Of note, SARS-CoV-1 infection is not associated with increased lymphocytes in the myocardium, so SARS-CoV-2 may have a greater potential to cause myocarditis than SARS-CoV-1.']} | Case 23-2020: A 76-Year-Old Woman Who Died from Covid-19 | null | N Engl J Med | 1594191600 | Essential workers during the COVID-19 pandemic face heightened levels of anxiety and depression due to increased work demands, lack of adequate personal protective equipment, fear of contracting the virus, and fear of spreading it to loved ones. This is a time of urgent need for mental health support for workers affected by the pandemic crisis. Clinicians may employ empirically supported interventions derived from cognitive behavioral therapy (CBT) and related therapies. Psychological First Aid, an evidence-based crisis intervention, may be utilized to emphasize basic needs and support, but is intended as an acute disaster intervention. Given that a pandemic is an ongoing and prolonged stressor, additional CBT-informed interventions are likely needed to fully support essential workers during these times. It is recommended that clinicians help essential worker clients meet their basic needs by modifying health and sleep habits where possible and helping them advocate for their needs using interpersonal effectiveness skills. Empathic listening, validation of the crisis at hand, and values clarification can aid the therapeutic relationship, help them feel a renewed sense of purpose and meaning in their careers and with their families, and facilitate behavior change consistent with chosen values. Self-monitoring through a daily diary can help clients focus their thoughts and recognize maladaptive patterns in their thoughts and behaviors. In tandem with these techniques, behavioral activation and coping strategies including relaxation, distress tolerance, and acceptance promote engaging in positive and adaptive activities. Finally, therapists can help clients reduce anxiety related to the pandemic by helping them limit information intake. | [] | other | PMC7367503 | null | 48 | [
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] | N Engl J Med. 2020 Jul 8;:NEJMcpc2004974 | NO-CC CODE |
|
Multi-slice Spiral Computed Tomography (CT), Coronal Reformatted Image Showing a Retroperitoneal Mass Located in Close Proximity to the Thoracic Duct Before (Panel a) and After (Panel b) Treatment With Triptoreline. | 2049-6958-6-5-313-1 | 7 | ac84dfd7b1d98b1ddad60d4440051ca5bbc2f67163220956980ed03ce23a9b2c | 2049-6958-6-5-313-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
244
] | [{'image_id': '2049-6958-6-5-313-2', 'image_file_name': '2049-6958-6-5-313-2.jpg', 'image_path': '../data/media_files/PMC3463088/2049-6958-6-5-313-2.jpg', 'caption': 'High Resolution Computed Tomography of the Lung Showing 5 to 7 mm Bilateral Cysts.', 'hash': '91f49bc0072fbe63f62e8754adaaedf3e908772ba35906c8b2b5c2333c381c76'}, {'image_id': '2049-6958-6-5-313-3', 'image_file_name': '2049-6958-6-5-313-3.jpg', 'image_path': '../data/media_files/PMC3463088/2049-6958-6-5-313-3.jpg', 'caption': 'Retrograde Bilateral Ureteropyelography. Right upper urinary tract showing extensive fistulous connections between urinary system and retroperitoneal lymphatics (panel a) and normally shaped left urinary tract (panel b).', 'hash': '535bb8737fa77a4c4ec83ec475f7d7997bfcb01e4a46701ed973aef0de473e31'}, {'image_id': '2049-6958-6-5-313-1', 'image_file_name': '2049-6958-6-5-313-1.jpg', 'image_path': '../data/media_files/PMC3463088/2049-6958-6-5-313-1.jpg', 'caption': 'Multi-slice Spiral Computed Tomography (CT), Coronal Reformatted Image Showing a Retroperitoneal Mass Located in Close Proximity to the Thoracic Duct Before (Panel a) and After (Panel b) Treatment With Triptoreline.', 'hash': 'ac84dfd7b1d98b1ddad60d4440051ca5bbc2f67163220956980ed03ce23a9b2c'}] | {'2049-6958-6-5-313-1': ['We describe a 42-year old Italian pre-menopausal woman, current smoker. She reported the use of hormonal therapy as a contraceptive measure, discontinued 2 years before presenting at our hospital, with irrelevant familiar and past medical history, apart from a voluntary abortion at age 25. No history of tuberous sclerosis was present. In July 2006 she reported an acute flu-like syndrome with fever and diffuse abdominal pain, relieved by paracetamol administration. One month later, chyluria associated to mild left flank pain appeared, in the absence of urinary symptoms; echographic examination of the abdomen revealed a tubular mass with a maximum diameter of 2 cm, as well as pseudocystic lesions around the right ureter with mild left hydronephrosis. A computerized tomography (CT) scan confirmed the presence of a large retroperitoneal mass, initially interpreted as conglomerated lymph nodes, dislocating both ureters, the lower tract of the vena cava and the abdominal tract of the aorta (Figure <xref ref-type="fig" rid="2049-6958-6-5-313-1">1</xref>, panel A). In the left kidney a 1.4 cm renal cyst was identified, while the uterus was enlarged by an endoluminal 2 cm nodule (later diagnosed as a myoma by transvaginal echography). Radiographic examination of the urinary tract by urography confirmed that the left ureter was compressed and dislocated by the neoformation. During a cystoscopic examination, white, milk-like urine from the left ureteral ostium was identified and a permanent left ureteral stent was inserted. In October 2006 the patient was admitted to the Oncology department, where a laparoscopy and biopsy of the retroperitoneal tissue were performed. Histologic examination revealed nodular infiltration by SM cells: immunohistochemical analysis showed that these muscle cells stained positive with antibodies specific for desmin (clone D240) and α-actin (clone HHF35), while they were negative for anti-CD34 (clone QBEND10), S100 protein (polyclonal), melanoma-associated antigen (clones HMB-45 and MART-1) and cytokeratin (clones MNF116, 35βH11 and 34βE12) antibodies. Staining for α and β estrogen receptors (ERs) was almost completely negative. A brain MRI was normal. Chest examination was normal as were arterial blood gases. Body plethysmography was within normal values (FEV, panel A). In the left kidney a 1.4 cm renal cyst was identified, while the uterus was enlarged by an endoluminal 2 cm nodule (later diagnosed as a myoma by transvaginal echography). Radiographic examination of the urinary tract by urography confirmed that the left ureter was compressed and dislocated by the neoformation. During a cystoscopic examination, white, milk-like urine from the left ureteral ostium was identified and a permanent left ureteral stent was inserted. In October 2006 the patient was admitted to the Oncology department, where a laparoscopy and biopsy of the retroperitoneal tissue were performed. Histologic examination revealed nodular infiltration by SM cells: immunohistochemical analysis showed that these muscle cells stained positive with antibodies specific for desmin (clone D240) and α-actin (clone HHF35), while they were negative for anti-CD34 (clone QBEND10), S100 protein (polyclonal), melanoma-associated antigen (clones HMB-45 and MART-1) and cytokeratin (clones MNF116, 35βH11 and 34βE12) antibodies. Staining for α and β estrogen receptors (ERs) was almost completely negative. A brain MRI was normal. Chest examination was normal as were arterial blood gases. Body plethysmography was within normal values (FEV1 3.2 L, 116% predicted; FVC 3.9 L, 121% predicted; total lung capacity [TLC] 6.3 L, 127% predicted; residual volume [RV] 1.7 L, 102% predicted), whereas carbon monoxide diffusion was slightly reduced (DLCO 77% predicted). Chest high-resolution computed tomography (HRCT) showed thin-walled cysts with an average diameter of 5 mm, diffused to both upper lobes (Figure <xref ref-type="fig" rid="2049-6958-6-5-313-2">2</xref>); the thoracic duct was moderately enlarged. Trans-bronchial biopsies were obtained and revealed the presence of aggregates of LAM cells with the same phenotypic pattern detected at retroperitoneal biopsy, i.e. HMB-45-negative LAM cells. ERs-β were expressed at low levels in the lung specimens only.); the thoracic duct was moderately enlarged. Trans-bronchial biopsies were obtained and revealed the presence of aggregates of LAM cells with the same phenotypic pattern detected at retroperitoneal biopsy, i.e. HMB-45-negative LAM cells. ERs-β were expressed at low levels in the lung specimens only.', 'Based on these findings a diagnosis of pulmonary and extrapulmonary LAM was established. In December 2006 treatment with triptoreline, a synthetic analogue of Gn-RH (at the dose of 3.75 mg every 4 weeks), was started; subsequent blood hormone dosages confirmed the induction of iatrogenic menopause. Seven months later, a CT scan revealed that the size of the retroperitoneal lymph angioleiomyoma was reduced by approximately 80% (Figure <xref ref-type="fig" rid="2049-6958-6-5-313-1">1</xref>, panel B); the caliber of the thoracic duct was also reduced, while lung cysts were unchanged. During this period the patient presented a mild, self-limiting chyluria on two occasions. Therefore, she underwent a retrograde bilateral ureteropyelography revealing a normal left urinary tract and absence of hydronephrosis, whereas, on the right side, extensive and dilated fistulous connections between the urinary tract and retroperitoneal lymphatics were present (Figure , panel B); the caliber of the thoracic duct was also reduced, while lung cysts were unchanged. During this period the patient presented a mild, self-limiting chyluria on two occasions. Therefore, she underwent a retrograde bilateral ureteropyelography revealing a normal left urinary tract and absence of hydronephrosis, whereas, on the right side, extensive and dilated fistulous connections between the urinary tract and retroperitoneal lymphatics were present (Figure <xref ref-type="fig" rid="2049-6958-6-5-313-3">3</xref>); the ureter stent was removed. In December 2007 the patient was clinically re-evaluated and was still asymptomatic; at that time, 18 months after initial presentation, lung function was basically unchanged (FEV); the ureter stent was removed. In December 2007 the patient was clinically re-evaluated and was still asymptomatic; at that time, 18 months after initial presentation, lung function was basically unchanged (FEV1 3.1 L, FVC 3.9 L, TLC 5.28 L, RV 1.32 L). Chyluria was absent and triptoreline treatment was continued.']} | Efficacy of hormonal suppression in a patient with chyluria due to lymphangioleiomyomatosis | [
"Chyluria",
"lymphangioleiomyoma",
"lymphangioleiomyomatosis",
"triptoreline"
] | Multidiscip Respir Med | 1320044400 | None | null | other | PMC3463088 | null | null | [
""
] | Multidiscip Respir Med. 2011 Oct 31; 6(5):313-317 | NO-CC CODE |
|
Preoperative axial and sagittal magnetic resonance imaging. | 10-1055-s-0034-1396431-i1400067-2 | 7 | c48249257725afbfd0f31701d20f2e96389e8bf7636f4a4ea426b6f2e37a66db | 10-1055-s-0034-1396431-i1400067-2.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
363
] | [{'image_id': '10-1055-s-0034-1396431-i1400067-1', 'image_file_name': '10-1055-s-0034-1396431-i1400067-1.jpg', 'image_path': '../data/media_files/PMC4516724/10-1055-s-0034-1396431-i1400067-1.jpg', 'caption': 'Preoperative anteroposterior and lateral radiographs.', 'hash': 'f669be00e9b482baa1595e675d41fae08f915a5423f30605dfb41e31d53c694d'}, {'image_id': '10-1055-s-0034-1396431-i1400067-6', 'image_file_name': '10-1055-s-0034-1396431-i1400067-6.jpg', 'image_path': '../data/media_files/PMC4516724/10-1055-s-0034-1396431-i1400067-6.jpg', 'caption': 'Iliac vein compression syndrome.', 'hash': 'c917d6d493f8ce1ed1476f19ea0ecb411d34f7ceeb78754bd1a1ef9592f11533'}, {'image_id': '10-1055-s-0034-1396431-i1400067-5', 'image_file_name': '10-1055-s-0034-1396431-i1400067-5.jpg', 'image_path': '../data/media_files/PMC4516724/10-1055-s-0034-1396431-i1400067-5.jpg', 'caption': 'Post-thrombectomy venogram.', 'hash': 'c4c7ce7a628a8a9e2e1593d7a8515d1f11a0507eca825f742f61190e8b98783e'}, {'image_id': '10-1055-s-0034-1396431-i1400067-2', 'image_file_name': '10-1055-s-0034-1396431-i1400067-2.jpg', 'image_path': '../data/media_files/PMC4516724/10-1055-s-0034-1396431-i1400067-2.jpg', 'caption': 'Preoperative axial and sagittal magnetic resonance imaging.', 'hash': 'c48249257725afbfd0f31701d20f2e96389e8bf7636f4a4ea426b6f2e37a66db'}, {'image_id': '10-1055-s-0034-1396431-i1400067-3', 'image_file_name': '10-1055-s-0034-1396431-i1400067-3.jpg', 'image_path': '../data/media_files/PMC4516724/10-1055-s-0034-1396431-i1400067-3.jpg', 'caption': 'Postoperative anteroposterior radiograph.', 'hash': 'bfe890f2260cdecb04ed107ddb7edce5cd4ed42d7ef22ae3e30d596f78c3a6bf'}, {'image_id': '10-1055-s-0034-1396431-i1400067-4', 'image_file_name': '10-1055-s-0034-1396431-i1400067-4.jpg', 'image_path': '../data/media_files/PMC4516724/10-1055-s-0034-1396431-i1400067-4.jpg', 'caption': 'Abdomen/pelvis coronal computed tomography. Long arrows show the thrombosed left common iliac vein. Short arrows show the interbody device placed at L5-S1.', 'hash': 'dcb01c9333e297ffa7bdce7533a5087671319163306d08eb1b4b54266550dad3'}] | {'10-1055-s-0034-1396431-i1400067-1': ['There was no evidence of fracture or instability (<xref rid="10-1055-s-0034-1396431-i1400067-1" ref-type="fig">Fig. 1</xref>). The MRI showed loss of disk height at L5–S1 with degenerative changes across the disk space. No significant disk herniation or narrowing of the canal was noted. There was compression at the L5 nerve roots secondary to foraminal narrowing (). The MRI showed loss of disk height at L5–S1 with degenerative changes across the disk space. No significant disk herniation or narrowing of the canal was noted. There was compression at the L5 nerve roots secondary to foraminal narrowing (<xref rid="10-1055-s-0034-1396431-i1400067-2" ref-type="fig">Fig. 2</xref>).).'], '10-1055-s-0034-1396431-i1400067-3': ['The patient had exhausted conservative measures and elected to proceed with an uncomplicated L5–S1 anterior lumbar interbody fusion using a lordotic polyetheretherketone cage, which was 16\u2009mm in height with 10 degrees of lordosis (<xref rid="10-1055-s-0034-1396431-i1400067-3" ref-type="fig">Fig. 3</xref>). InFuse Bone Graft recombinant human bone morphogenic protein 2 (rhBMP-2) (Medtronic Sofamor Danek, Memphis, Tennessee, United States) 5.6 mL was applied to a collagen sponge and inserted into the cage. There was no excess retraction of the vasculature; the bifurcation above L5–S1 left ample space to prepare the disk space and insert the implant. The procedure was completed without vascular injury. The patient did well postoperatively and was discharged within 5 days of the procedure. In accordance with our standard protocol, only mechanical deep venous thrombosis (DVT) prophylaxis was used in the hospital, and no chemoprophylaxis was used postoperatively.). InFuse Bone Graft recombinant human bone morphogenic protein 2 (rhBMP-2) (Medtronic Sofamor Danek, Memphis, Tennessee, United States) 5.6 mL was applied to a collagen sponge and inserted into the cage. There was no excess retraction of the vasculature; the bifurcation above L5–S1 left ample space to prepare the disk space and insert the implant. The procedure was completed without vascular injury. The patient did well postoperatively and was discharged within 5 days of the procedure. In accordance with our standard protocol, only mechanical deep venous thrombosis (DVT) prophylaxis was used in the hospital, and no chemoprophylaxis was used postoperatively.'], '10-1055-s-0034-1396431-i1400067-4': ['Although this patient certainly had risk factors for DVT formation (postoperative status, anterior spine surgery, previous smoker, and oral contraceptive use), due to the extreme size of the thrombus, the vascular surgery and hematology departments were consulted and a hypercoagulable workup was done, which was negative for a genetic predisposition for DVT. The role of rhBMP-2 in contributing to pelvic thrombus formation is thus far unclear. An abdominal computed tomography (CT) scan was obtained with contrast showing a large thrombus anterior to the L5 vertebral body (<xref rid="10-1055-s-0034-1396431-i1400067-4" ref-type="fig">Fig. 4</xref>). A venogram was performed and found subsequent thrombolysis from a popliteal access point. An extensive thrombus was found in the left common iliac vein and the adjacent inferior vena cava. The anatomic compression of the left femoral vein between the right iliac artery and the L5 vertebral body was noted and the diagnosis of May-Thurner syndrome was made. Tissue plasminogen activator was used as a thrombolytic agent. Serial venograms were performed 24 and 48 hours after the initial thrombolysis and showed resolution of flow in the left common iliac vein (). A venogram was performed and found subsequent thrombolysis from a popliteal access point. An extensive thrombus was found in the left common iliac vein and the adjacent inferior vena cava. The anatomic compression of the left femoral vein between the right iliac artery and the L5 vertebral body was noted and the diagnosis of May-Thurner syndrome was made. Tissue plasminogen activator was used as a thrombolytic agent. Serial venograms were performed 24 and 48 hours after the initial thrombolysis and showed resolution of flow in the left common iliac vein (<xref rid="10-1055-s-0034-1396431-i1400067-5" ref-type="fig">Fig. 5</xref>). During the third venogram, stents were placed in the left common iliac vein and external iliac veins and the sheath was removed. The patient continued heparin therapy until she was transitioned to coumadin, which was continued for 6 months post-thrombolysis.). During the third venogram, stents were placed in the left common iliac vein and external iliac veins and the sheath was removed. The patient continued heparin therapy until she was transitioned to coumadin, which was continued for 6 months post-thrombolysis.'], '10-1055-s-0034-1396431-i1400067-6': ['May-Thurner syndrome or IVCS is an anatomic variant that results in compression of the left iliac vein by the right iliac artery. In 1851, Virchow described a similar compression phenomenon.1 However, it was not until 1957 that May and Thurner described a syndrome in which compression between the L5 vertebral body and the right iliac artery caused compression of the left iliac vein. They postulated that in response to repetitive trauma to the vein at the site of bony contact, thickening of the vascular endothelium leads to a “spur” of intimal proliferation in the vein wall and increased compression and obstruction of the vein over time.2 This cycle ends with an increased predisposition to form DVT in the left lower extremity. <xref rid="10-1055-s-0034-1396431-i1400067-6" ref-type="fig">Fig. 6</xref> illustrates the anatomic compression of the left iliac vein by the crossing right iliac artery and the resultant lateral, double lumen, and webbing spur patterns. In detailed dissections of 430 cadavers and examinations of the vascular histopathology, May and Thurner found compression of the left iliac vein between the right iliac artery and the L5 vertebral body in 22% of their specimens. Spurs were categorized as illustrates the anatomic compression of the left iliac vein by the crossing right iliac artery and the resultant lateral, double lumen, and webbing spur patterns. In detailed dissections of 430 cadavers and examinations of the vascular histopathology, May and Thurner found compression of the left iliac vein between the right iliac artery and the L5 vertebral body in 22% of their specimens. Spurs were categorized as lateral with two spurs encroaching toward the lumen, central with a single septation across the lumen, or partial obliteration corresponding to webbing across the lumen.2\n']} | Extensive Deep Venous Thrombosis Resulting from Anterior Lumbar Spine Surgery in a Patient with Iliac Vein Compression Syndrome: A Case Report and Literature Review | [
"May-Thurner",
"anatomy",
"thrombosis",
"DVT",
"lumbar spine surgery",
"ALIF"
] | Global Spine J | 1440226800 | Study Design Case report. Objective Synovial cysts in the subaxial cervical spine are rare and are most commonly reported at the cervicothoracic junction. Only six cases of symptomatic C5-C6 synovial cysts have been reported in the literature; the condition is usually treated with decompressive laminectomy. We present a patient with a synovial cyst arising from the C5-C6 facet joint, associated with spondylolisthesis, and causing radiculomyelopathy. The patient was treated with a posterior excision of the cyst, decompressive laminectomy, and fusion. Methods A 67-year-old man had vertebral canal stenosis at C5-C6 secondary to a synovial cyst and spondylolisthesis with symptoms and signs of radiculopathy and myelopathy. Surgical management involved C5-C6 posterior decompressive laminectomy and excision of the cyst and C4-C6 instrumented fusion with lateral mass screws and rods. A literature review of symptomatic cervical synovial cysts is presented. Results The imaging studies identified grade I spondylolisthesis and a 3.3 × 4.3-mm extradural lentiform-like mass associated with focal compression of the spinal cord and exiting the C6 nerve root. After the surgery, the patient had an immediate full recovery and was asymptomatic by the 6-month examination. No operative complications were reported. The histologic report confirmed the presence of a synovial cyst. Conclusions C5-C6 is an unusual localization for symptomatic synovial cysts. Similar cases reported in the literature achieved excellent results after cyst excision and decompressive laminectomy. Because spondylolisthesis plus laminectomy are risk factors for segmental instability in the cervical spine, we report a case of a C5-C6 facet synovial cyst successfully treated with posterior laminectomy and C4-C6 fusion. | [] | other | PMC4516724 | null | 17 | [
"{'Citation': 'Cho B Y, Zhang H Y, Kim H S. Synovial cyst in the cervical region causing severe myelopathy. Yonsei Med J. 2004;45(3):539–542.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15227744'}}}",
"{'Citation': 'Khan A M, Girardi F. Spinal lumbar synovial cysts. Diagnosis and management challenge. Eur Spine J. 2006;15(8):1176–1182.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3233964'}, {'@IdType': 'pubmed', '#text': '16440202'}]}}",
"{'Citation': 'Shima Y, Rothman S L, Yasura K, Takahashi S. Degenerative intraspinal cyst of the cervical spine: case report and literature review. Spine (Phila Pa 1976) 2002;27(1):E18–E22.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11805654'}}}",
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"{'Citation': 'Lyons M K, Birch B D, Krauss W E, Patel N P, Nottmeier E W, Boucher O K. Subaxial cervical synovial cysts: report of 35 histologically confirmed surgically treated cases and review of the literature. Spine (Phila Pa 1976) 2011;36(20):E1285–E1289.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21358479'}}}",
"{'Citation': 'Holtzman R N, Dubin R, Yang W C, Rorat E, Liu H M, Leeds N E. Bilateral symptomatic intraspinal T12-L1 synovial cysts. Surg Neurol. 1987;28(3):225–230.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3629450'}}}",
"{'Citation': 'McGuigan C, Stevens J, Gabriel C M. A synovial cyst in the cervical spine causing acute spinal cord compression. Neurology. 2005;65(8):1293.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16247060'}}}",
"{'Citation': 'Colen C B, Rengachary S. Spontaneous resolution of a cervical synovial cyst. Case illustration. J Neurosurg Spine. 2006;4(2):186.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16506489'}}}",
"{'Citation': 'Jabre A, Shahbabian S, Keller J T. Synovial cyst of the cervical spine. Neurosurgery. 1987;20(2):316–318.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3561742'}}}",
"{'Citation': 'Farrokh D. Lumbar intraspinal synovial cysts of different etiologies: diagnosis by CT and MR imaging. J Belge Radiol. 1998;81(6):275–278.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10063761'}}}",
"{'Citation': 'Davis R, Iliya A, Roque C, Pampati M. The advantage of magnetic resonance imaging in diagnosis of a lumbar synovial cyst. Spine (Phila Pa 1976) 1990;15(3):244–246.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2353265'}}}",
"{'Citation': 'Conrad M R, Pitkethly D T. Bilateral synovial cysts creating spinal stenosis: CT diagnosis. J Comput Assist Tomogr. 1987;11(1):196–197.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3805420'}}}",
"{'Citation': 'Apostolaki E, Davies A M, Evans N, Cassar-Pullicino V N. MR imaging of lumbar facet joint synovial cysts. Eur Radiol. 2000;10(4):615–623.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10795544'}}}",
"{'Citation': 'Kostanian V J, Mathews M S. CT guided aspiration of a cervical synovial cyst. Case report and technical note. Interv Neuroradiol. 2007;13(3):295–298.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3345493'}, {'@IdType': 'pubmed', '#text': '20566122'}]}}",
"{'Citation': 'Uschold T, Abla A A, Fusco D, Bristol R E, Nakaji P. Supracerebellar infratentorial endoscopically controlled resection of pineal lesions: case series and operative technique. J Neurosurg Pediatr. 2011;8(6):554–564.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22132912'}}}",
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] | Global Spine J. 2015 Aug 22; 5(4):e22-e27 | NO-CC CODE |
|
Follow-up computed tomography (CT) of craniocervical junction after 2 years shows no tumor recurrence. (A) CT scan sagittal cut; (B) CT scan axial cut at the C2 body level. | 10-1055-s-0034-1396433-i1400107-5 | 7 | 56552a3609c1a8819eff081f8fabac4043f560a837fb5a5e0ded873be99fcd2d | 10-1055-s-0034-1396433-i1400107-5.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
369
] | [{'image_id': '10-1055-s-0034-1396433-i1400107-5', 'image_file_name': '10-1055-s-0034-1396433-i1400107-5.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-5.jpg', 'caption': 'Follow-up computed tomography (CT) of craniocervical junction after 2 years shows no tumor recurrence. (A) CT scan sagittal cut; (B) CT scan axial cut at the C2 body level.', 'hash': '56552a3609c1a8819eff081f8fabac4043f560a837fb5a5e0ded873be99fcd2d'}, {'image_id': '10-1055-s-0034-1396433-i1400107-2', 'image_file_name': '10-1055-s-0034-1396433-i1400107-2.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-2.jpg', 'caption': 'Magnetic resonance imaging of the upper cervical spine showing low signal intensity on T1, intermediate signal on T2, and intensely enhanced postcontrast. Axial cuts demonstrate an extensive soft tissue mass. (A, B) T2-weighted images, sagittal and axial cuts; (C, D) T1-weighted images, sagittal and axial cuts; (E) T1-weighted image, postcontrast, sagittal cut.', 'hash': 'b25cf6dede330d79178840dad8346130a09be59c91f7e592a949372f1a1c9f38'}, {'image_id': '10-1055-s-0034-1396433-i1400107-3', 'image_file_name': '10-1055-s-0034-1396433-i1400107-3.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-3.jpg', 'caption': '(A) Postoperative X-ray; (B) postoperative sagittal magnetic resonance imaging; (C) postoperative sagittal computed tomography scan.', 'hash': '2b492f0e2a05dbfa7c703b2e2e8df7ec2bb8687fa27830f6fb2e3c4c4ed37615'}, {'image_id': '10-1055-s-0034-1396433-i1400107-4', 'image_file_name': '10-1055-s-0034-1396433-i1400107-4.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-4.jpg', 'caption': '(A) Histopathology showing the giant cell tumor. (B) High-power field of the histopathology showing the giant cell tumor.', 'hash': 'f7bce178a86bbf1c5e565c6292544524cf70593b067d8dc6101d11a212fe46c7'}, {'image_id': '10-1055-s-0034-1396433-i1400107-1', 'image_file_name': '10-1055-s-0034-1396433-i1400107-1.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-1.jpg', 'caption': 'Computed tomography (CT) scan of the C2 axis showing the destructive lesion involving the odontoid, C2 body, and lateral masses with an element of atlantoaxial rotational instability. (A) CT scan sagittal cut; (B) CT scan coronal; (C) CT scan axial cut at the odontoid level; (D) CT scan axial cut at the C2 body level.', 'hash': '6c1de5e58d7bd20bdc6d5a37c8c12333b6364b51d960310401a13de0bcdfcf61'}] | {'10-1055-s-0034-1396433-i1400107-1': ['The cervical spine plain X-ray showed an expansile lytic lesion at C2. The CT scan revealed the details of the bony expansile lytic lesion of C2 involving the body, pedicle, and odontoid process with extensive thinning of the cortex. The lesion was associated with a soft tissue mass extending to the inside of the neuronal canal and causing effacement of the spinal cord. There was also mild C1–C2 rotational instability, as shown in (<xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">Fig. 1A</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">B</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">C</xref>, and , and <xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">D</xref>).).'], '10-1055-s-0034-1396433-i1400107-2': ['The MRI with contrast revealed the extension of the lesion inside the canal with moderate compromise of the cervical spinal cord with effacement and extension of the lesion to the pedicles and lateral masses encasing both vertebral arteries. The lesion showed a low-intensity signal on T1, intermediate heterogeneous signal on T2, and intense homogenous contrast enhancement, as shown in <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">Fig. 2A</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">B</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">C</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">D</xref>, and , and <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">E</xref>..'], '10-1055-s-0034-1396433-i1400107-3': ['Surgery revealed a near completely destroyed C2 body and odontoid, and the tumor mass was an eggshell cortex overlapping the C3. The turmor was firm, brownish yellow, and it was friable and bled easily. Nearly complete excision of the tumor was accomplished, with excision of the C2 body, odontoid, and part of the lateral mass. Reconstruction of the spine was performed with a fibular graft. A 3-mm-deep trough was created at the upper end of the graft to fit the anterior arch of C1 to maximize stability, and another trough was created at the body of C3 to fit the lower end of the graft. The graft was inserted by a press fit. Additional stability was applied by adding a plate from the C1 arch to the body of C3 (<xref rid="10-1055-s-0034-1396433-i1400107-3" ref-type="fig">Fig. 3A</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-3" ref-type="fig">B</xref>, and , and <xref rid="10-1055-s-0034-1396433-i1400107-3" ref-type="fig">C</xref>).).'], '10-1055-s-0034-1396433-i1400107-4': ['The final pathology supported the diagnosis of GCTB at our pathology laboratory and was confirmed by an international pathology laboratory, as shown in <xref rid="10-1055-s-0034-1396433-i1400107-4" ref-type="fig">Fig. 4A</xref> and and <xref rid="10-1055-s-0034-1396433-i1400107-4" ref-type="fig">B</xref>. Our institution\'s tumor board advised regular radiologic follow-up with no additional adjuvant therapy.. Our institution\'s tumor board advised regular radiologic follow-up with no additional adjuvant therapy.'], '10-1055-s-0034-1396433-i1400107-5': ['The patient was regularly followed every 6 months with no evidence of recurrence or cervical spine instability for 2 years (<xref rid="10-1055-s-0034-1396433-i1400107-5" ref-type="fig">Fig. 5A</xref> and and <xref rid="10-1055-s-0034-1396433-i1400107-5" ref-type="fig">B</xref>).).']} | Pediatric Upper Cervical Spine Giant Cell Tumor: Case Report | [
"giant cell tumor",
"pediatric tumors",
"C2 tumors",
"retropharyngeal approach",
"C2 fixation"
] | Global Spine J | 1439794800 | Study Design Retrospective comparative study. Objective A narrow spinal canal is an important risk factor for predicting a spinal cord injury (SCI); however, the radiologic parameters have not been fully established. The authors conducted a comparative study to forecast SCI risk by determining a predictive spinal canal diameter (SCD) cutoff value from magnetic resonance image (MRI) in the Korean population. Methods On T2-weighted MRI of the cervical spine, the SCD at the pedicle (SCDpedicle) and the intervertebral disk level (SCDdisk) were measured in patients with SCI without spinal instability and in healthy subjects. Additionally, the vertebral body diameter (Dvertebral body) and intervertebral disk diameter (Dintervertebral disk) were measured, and the two ratios (SCDpedicle to Dvertebral body and SCDdisk to Dintervertebral disk) were calculated. In the SCI group, the extent of high signal intensity on the T2-weighted midsagittal MRI was determined. Results The data obtained from 20 patients in the SCI group (18 men, mean age 61.35 years) and 65 individuals in the control group (47 men, mean age 57.05 years) was compared. All the parameters including the SCD and the calculated ratios were significantly smaller in the SCI group than in the control group. Among them, the area under the receiver operating curve (AUC) value for the SCDdisk-to-Dintervertebral disk ratio at C2-C3, with a cutoff ratio value of 0.59, provided the greatest positive predictive value. A low SCDdisk-to-Dintervertebral disk ratio at C4-C5 and the presence of >40 mm of high signal intensity on the MRI were related with the presence of complete SCI. Conclusion Because the C2-C3 level is relatively wide compared with the subaxial cervical spine, a small ratio at C2-C3 provided the greatest positive predictive value in SCI. Complete SCI is associated with a small SCDdisk-to-Dintervertebral disk ratio at C4-C5 and with extensive high signal intensity on MRI. | [] | other | PMC4516742 | null | 35 | [
"{'Citation': 'Aarabi B, Alexander M, Mirvis S E. et al.Predictors of outcome in acute traumatic central cord syndrome due to spinal stenosis. J Neurosurg Spine. 2011;14(1):122–130.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21166485'}}}",
"{'Citation': 'Lamothe G, Muller F, Vital J M, Goossens D, Barat M. Evolution of spinal cord injuries due to cervical canal stenosis without radiographic evidence of trauma (SCIWORET): a prospective study. Ann Phys Rehabil Med. 2011;54(4):213–224.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21420922'}}}",
"{'Citation': 'Aebli N, Ruegg T B, Wicki A G, Petrou N, Krebs J. Predicting the risk and severity of acute spinal cord injury after a minor trauma to the cervical spine. Spine J. 2013;13(6):597–604.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23523437'}}}",
"{'Citation': 'Tewari M K Gifti D S Singh P et al.Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients Surg Neurol 2005633204–209., discussion 209', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15734500'}}}",
"{'Citation': 'Takao T, Morishita Y, Okada S. et al.Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation. Eur Spine J. 2013;22(10):2228–2231.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3804697'}, {'@IdType': 'pubmed', '#text': '23793521'}]}}",
"{'Citation': \"Song K J, Choi B W, Kim S J, Kim G H, Kim Y S, Song J H. The relationship between spinal stenosis and neurological outcome in traumatic cervical spine injury: an analysis using Pavlov's ratio, spinal cord area, and spinal canal area. Clin Orthop Surg. 2009;1(1):11–18.\", 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2766695'}, {'@IdType': 'pubmed', '#text': '19884992'}]}}",
"{'Citation': 'Harrop J S Sharan A Ratliff J Central cord injury: pathophysiology, management, and outcomes Spine J 20066(6, Suppl):198S–206S.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17097539'}}}",
"{'Citation': 'Firooznia H, Ahn J H, Rafii M, Ragnarsson K T. Sudden quadriplegia after a minor trauma. The role of preexisting spinal stenosis. Surg Neurol. 1985;23(2):165–168.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3966211'}}}",
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"{'Citation': 'Aebli N, Wicki A G, Rüegg T B, Petrou N, Eisenlohr H, Krebs J. The Torg-Pavlov ratio for the prediction of acute spinal cord injury after a minor trauma to the cervical spine. Spine J. 2013;13(6):605–612.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23318107'}}}",
"{'Citation': 'Kirshblum S C Memmo P Kim N Campagnolo D Millis S; American Spinal Injury Association. Comparison of the revised 2000 American Spinal Injury Association classification standards with the 1996 guidelines Am J Phys Med Rehabil 2002817502–505.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12131176'}}}",
"{'Citation': 'American College of Surgeons, Committee on Trauma . Chicago, IL: Committee on Trauma; 1999. Resources for the Optimal Care of the Injured Patient.'}",
"{'Citation': 'Torg J S, Pavlov H, Genuario S E. et al.Neurapraxia of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am. 1986;68(9):1354–1370.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3782207'}}}",
"{'Citation': 'Pettersson K, Kärrholm J, Toolanen G, Hildingsson C. Decreased width of the spinal canal in patients with chronic symptoms after whiplash injury. Spine (Phila Pa 1976) 1995;20(15):1664–1667.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7482014'}}}",
"{'Citation': 'Eismont F J, Clifford S, Goldberg M, Green B. Cervical sagittal spinal canal size in spine injury. Spine (Phila Pa 1976) 1984;9(7):663–666.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '6505832'}}}",
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"{'Citation': 'Torg J S, Pavlov H. Cervical spinal stenosis with cord neurapraxia and transient quadriplegia. Clin Sports Med. 1987;6(1):115–133.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3334023'}}}",
"{'Citation': 'Pavlov H, Torg J S, Robie B, Jahre C. Cervical spinal stenosis: determination with vertebral body ratio method. Radiology. 1987;164(3):771–775.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3615879'}}}",
"{'Citation': 'Gupta S K, Roy R C, Srivastava A. Sagittal diameter of the cervical canal in normal Indian adults. Clin Radiol. 1982;33(6):681–685.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7140151'}}}",
"{'Citation': 'Hashimoto I, Tak Y K. The true sagittal diameter of the cervical spinal canal and its diagnostic significance in cercical myelopathy. J Neurosurg. 1977;47(6):912–916.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '925745'}}}",
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"{'Citation': 'Bednarik J, Kadanka Z, Dusek L. et al.Presymptomatic spondylotic cervical cord compression. Spine (Phila Pa 1976) 2004;29(20):2260–2269.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15480138'}}}",
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"{'Citation': 'Roth E J, Lawler M H, Yarkony G M. Traumatic central cord syndrome: clinical features and functional outcomes. Arch Phys Med Rehabil. 1990;71(1):18–23.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2297304'}}}",
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] | Global Spine J. 2015 Aug 17; 5(4):e28-e33 | NO-CC CODE |
|
Magnetic resonance imaging of the upper cervical spine showing low signal intensity on T1, intermediate signal on T2, and intensely enhanced postcontrast. Axial cuts demonstrate an extensive soft tissue mass. (A, B) T2-weighted images, sagittal and axial cuts; (C, D) T1-weighted images, sagittal and axial cuts; (E) T1-weighted image, postcontrast, sagittal cut. | 10-1055-s-0034-1396433-i1400107-2 | 7 | b25cf6dede330d79178840dad8346130a09be59c91f7e592a949372f1a1c9f38 | 10-1055-s-0034-1396433-i1400107-2.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
526
] | [{'image_id': '10-1055-s-0034-1396433-i1400107-5', 'image_file_name': '10-1055-s-0034-1396433-i1400107-5.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-5.jpg', 'caption': 'Follow-up computed tomography (CT) of craniocervical junction after 2 years shows no tumor recurrence. (A) CT scan sagittal cut; (B) CT scan axial cut at the C2 body level.', 'hash': '56552a3609c1a8819eff081f8fabac4043f560a837fb5a5e0ded873be99fcd2d'}, {'image_id': '10-1055-s-0034-1396433-i1400107-2', 'image_file_name': '10-1055-s-0034-1396433-i1400107-2.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-2.jpg', 'caption': 'Magnetic resonance imaging of the upper cervical spine showing low signal intensity on T1, intermediate signal on T2, and intensely enhanced postcontrast. Axial cuts demonstrate an extensive soft tissue mass. (A, B) T2-weighted images, sagittal and axial cuts; (C, D) T1-weighted images, sagittal and axial cuts; (E) T1-weighted image, postcontrast, sagittal cut.', 'hash': 'b25cf6dede330d79178840dad8346130a09be59c91f7e592a949372f1a1c9f38'}, {'image_id': '10-1055-s-0034-1396433-i1400107-3', 'image_file_name': '10-1055-s-0034-1396433-i1400107-3.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-3.jpg', 'caption': '(A) Postoperative X-ray; (B) postoperative sagittal magnetic resonance imaging; (C) postoperative sagittal computed tomography scan.', 'hash': '2b492f0e2a05dbfa7c703b2e2e8df7ec2bb8687fa27830f6fb2e3c4c4ed37615'}, {'image_id': '10-1055-s-0034-1396433-i1400107-4', 'image_file_name': '10-1055-s-0034-1396433-i1400107-4.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-4.jpg', 'caption': '(A) Histopathology showing the giant cell tumor. (B) High-power field of the histopathology showing the giant cell tumor.', 'hash': 'f7bce178a86bbf1c5e565c6292544524cf70593b067d8dc6101d11a212fe46c7'}, {'image_id': '10-1055-s-0034-1396433-i1400107-1', 'image_file_name': '10-1055-s-0034-1396433-i1400107-1.jpg', 'image_path': '../data/media_files/PMC4516742/10-1055-s-0034-1396433-i1400107-1.jpg', 'caption': 'Computed tomography (CT) scan of the C2 axis showing the destructive lesion involving the odontoid, C2 body, and lateral masses with an element of atlantoaxial rotational instability. (A) CT scan sagittal cut; (B) CT scan coronal; (C) CT scan axial cut at the odontoid level; (D) CT scan axial cut at the C2 body level.', 'hash': '6c1de5e58d7bd20bdc6d5a37c8c12333b6364b51d960310401a13de0bcdfcf61'}] | {'10-1055-s-0034-1396433-i1400107-1': ['The cervical spine plain X-ray showed an expansile lytic lesion at C2. The CT scan revealed the details of the bony expansile lytic lesion of C2 involving the body, pedicle, and odontoid process with extensive thinning of the cortex. The lesion was associated with a soft tissue mass extending to the inside of the neuronal canal and causing effacement of the spinal cord. There was also mild C1–C2 rotational instability, as shown in (<xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">Fig. 1A</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">B</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">C</xref>, and , and <xref rid="10-1055-s-0034-1396433-i1400107-1" ref-type="fig">D</xref>).).'], '10-1055-s-0034-1396433-i1400107-2': ['The MRI with contrast revealed the extension of the lesion inside the canal with moderate compromise of the cervical spinal cord with effacement and extension of the lesion to the pedicles and lateral masses encasing both vertebral arteries. The lesion showed a low-intensity signal on T1, intermediate heterogeneous signal on T2, and intense homogenous contrast enhancement, as shown in <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">Fig. 2A</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">B</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">C</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">D</xref>, and , and <xref rid="10-1055-s-0034-1396433-i1400107-2" ref-type="fig">E</xref>..'], '10-1055-s-0034-1396433-i1400107-3': ['Surgery revealed a near completely destroyed C2 body and odontoid, and the tumor mass was an eggshell cortex overlapping the C3. The turmor was firm, brownish yellow, and it was friable and bled easily. Nearly complete excision of the tumor was accomplished, with excision of the C2 body, odontoid, and part of the lateral mass. Reconstruction of the spine was performed with a fibular graft. A 3-mm-deep trough was created at the upper end of the graft to fit the anterior arch of C1 to maximize stability, and another trough was created at the body of C3 to fit the lower end of the graft. The graft was inserted by a press fit. Additional stability was applied by adding a plate from the C1 arch to the body of C3 (<xref rid="10-1055-s-0034-1396433-i1400107-3" ref-type="fig">Fig. 3A</xref>, , <xref rid="10-1055-s-0034-1396433-i1400107-3" ref-type="fig">B</xref>, and , and <xref rid="10-1055-s-0034-1396433-i1400107-3" ref-type="fig">C</xref>).).'], '10-1055-s-0034-1396433-i1400107-4': ['The final pathology supported the diagnosis of GCTB at our pathology laboratory and was confirmed by an international pathology laboratory, as shown in <xref rid="10-1055-s-0034-1396433-i1400107-4" ref-type="fig">Fig. 4A</xref> and and <xref rid="10-1055-s-0034-1396433-i1400107-4" ref-type="fig">B</xref>. Our institution\'s tumor board advised regular radiologic follow-up with no additional adjuvant therapy.. Our institution\'s tumor board advised regular radiologic follow-up with no additional adjuvant therapy.'], '10-1055-s-0034-1396433-i1400107-5': ['The patient was regularly followed every 6 months with no evidence of recurrence or cervical spine instability for 2 years (<xref rid="10-1055-s-0034-1396433-i1400107-5" ref-type="fig">Fig. 5A</xref> and and <xref rid="10-1055-s-0034-1396433-i1400107-5" ref-type="fig">B</xref>).).']} | Pediatric Upper Cervical Spine Giant Cell Tumor: Case Report | [
"giant cell tumor",
"pediatric tumors",
"C2 tumors",
"retropharyngeal approach",
"C2 fixation"
] | Global Spine J | 1439794800 | Study Design Retrospective comparative study. Objective A narrow spinal canal is an important risk factor for predicting a spinal cord injury (SCI); however, the radiologic parameters have not been fully established. The authors conducted a comparative study to forecast SCI risk by determining a predictive spinal canal diameter (SCD) cutoff value from magnetic resonance image (MRI) in the Korean population. Methods On T2-weighted MRI of the cervical spine, the SCD at the pedicle (SCDpedicle) and the intervertebral disk level (SCDdisk) were measured in patients with SCI without spinal instability and in healthy subjects. Additionally, the vertebral body diameter (Dvertebral body) and intervertebral disk diameter (Dintervertebral disk) were measured, and the two ratios (SCDpedicle to Dvertebral body and SCDdisk to Dintervertebral disk) were calculated. In the SCI group, the extent of high signal intensity on the T2-weighted midsagittal MRI was determined. Results The data obtained from 20 patients in the SCI group (18 men, mean age 61.35 years) and 65 individuals in the control group (47 men, mean age 57.05 years) was compared. All the parameters including the SCD and the calculated ratios were significantly smaller in the SCI group than in the control group. Among them, the area under the receiver operating curve (AUC) value for the SCDdisk-to-Dintervertebral disk ratio at C2-C3, with a cutoff ratio value of 0.59, provided the greatest positive predictive value. A low SCDdisk-to-Dintervertebral disk ratio at C4-C5 and the presence of >40 mm of high signal intensity on the MRI were related with the presence of complete SCI. Conclusion Because the C2-C3 level is relatively wide compared with the subaxial cervical spine, a small ratio at C2-C3 provided the greatest positive predictive value in SCI. Complete SCI is associated with a small SCDdisk-to-Dintervertebral disk ratio at C4-C5 and with extensive high signal intensity on MRI. | [] | other | PMC4516742 | null | 35 | [
"{'Citation': 'Aarabi B, Alexander M, Mirvis S E. et al.Predictors of outcome in acute traumatic central cord syndrome due to spinal stenosis. J Neurosurg Spine. 2011;14(1):122–130.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21166485'}}}",
"{'Citation': 'Lamothe G, Muller F, Vital J M, Goossens D, Barat M. Evolution of spinal cord injuries due to cervical canal stenosis without radiographic evidence of trauma (SCIWORET): a prospective study. Ann Phys Rehabil Med. 2011;54(4):213–224.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21420922'}}}",
"{'Citation': 'Aebli N, Ruegg T B, Wicki A G, Petrou N, Krebs J. Predicting the risk and severity of acute spinal cord injury after a minor trauma to the cervical spine. Spine J. 2013;13(6):597–604.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23523437'}}}",
"{'Citation': 'Tewari M K Gifti D S Singh P et al.Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients Surg Neurol 2005633204–209., discussion 209', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15734500'}}}",
"{'Citation': 'Takao T, Morishita Y, Okada S. et al.Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation. Eur Spine J. 2013;22(10):2228–2231.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3804697'}, {'@IdType': 'pubmed', '#text': '23793521'}]}}",
"{'Citation': \"Song K J, Choi B W, Kim S J, Kim G H, Kim Y S, Song J H. The relationship between spinal stenosis and neurological outcome in traumatic cervical spine injury: an analysis using Pavlov's ratio, spinal cord area, and spinal canal area. Clin Orthop Surg. 2009;1(1):11–18.\", 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2766695'}, {'@IdType': 'pubmed', '#text': '19884992'}]}}",
"{'Citation': 'Harrop J S Sharan A Ratliff J Central cord injury: pathophysiology, management, and outcomes Spine J 20066(6, Suppl):198S–206S.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17097539'}}}",
"{'Citation': 'Firooznia H, Ahn J H, Rafii M, Ragnarsson K T. Sudden quadriplegia after a minor trauma. The role of preexisting spinal stenosis. Surg Neurol. 1985;23(2):165–168.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3966211'}}}",
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] | Global Spine J. 2015 Aug 17; 5(4):e28-e33 | NO-CC CODE |
|
MRI image of the thoracic spine showing intraspinal hemorrhage. MRI, magnetic resonance imaging. | 10-1055-s-0034-1395491-i140049-4 | 7 | f4d6acb63436c6168f6509b5f1dc1bae7a2e9a9386ab0606c9c1e723204aa612 | 10-1055-s-0034-1395491-i140049-4.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
519,
800
] | [{'image_id': '10-1055-s-0034-1395491-i140049-3', 'image_file_name': '10-1055-s-0034-1395491-i140049-3.jpg', 'image_path': '../data/media_files/PMC4520959/10-1055-s-0034-1395491-i140049-3.jpg', 'caption': 'Angiographic image of the aneurysm. There is no “blush,” no active hemorrhage, seen on the image.', 'hash': '3c927394a3c6936b10e5f8d9da11fece8706bcbbb479201158478eba75df8af0'}, {'image_id': '10-1055-s-0034-1395491-i140049-4', 'image_file_name': '10-1055-s-0034-1395491-i140049-4.jpg', 'image_path': '../data/media_files/PMC4520959/10-1055-s-0034-1395491-i140049-4.jpg', 'caption': 'MRI image of the thoracic spine showing intraspinal hemorrhage. MRI, magnetic resonance imaging.', 'hash': 'f4d6acb63436c6168f6509b5f1dc1bae7a2e9a9386ab0606c9c1e723204aa612'}, {'image_id': '10-1055-s-0034-1395491-i140049-2', 'image_file_name': '10-1055-s-0034-1395491-i140049-2.jpg', 'image_path': '../data/media_files/PMC4520959/10-1055-s-0034-1395491-i140049-2.jpg', 'caption': '3D-reconstruction image of the aneurysm. 3D, three-dimensional.', 'hash': '55a04972bcb9d2a9b80f84ba36314fb6862f95a18a19b2c772e3fba1ccd10292'}, {'image_id': '10-1055-s-0034-1395491-i140049-1', 'image_file_name': '10-1055-s-0034-1395491-i140049-1.jpg', 'image_path': '../data/media_files/PMC4520959/10-1055-s-0034-1395491-i140049-1.jpg', 'caption': 'CT scan which shows the dissection in the aneurysm at the celiac trunk and the surrounding intra-abdominal hemorrhage. CT, computed tomography.', 'hash': '61a1b2cc28817d9a7de0ec220e6c03ea91186803057e82cc9f358b5ef00d928d'}] | {'10-1055-s-0034-1395491-i140049-1': ['Computed tomography (CT) angiography showed an intra-abdominal, retroperitoneal hematoma with a stenotic celiac trunk and a poststenotic saccular aneurysm (<xref rid="10-1055-s-0034-1395491-i140049-1" ref-type="fig">Figs. 1</xref> and and <xref rid="10-1055-s-0034-1395491-i140049-2" ref-type="fig">2</xref>). The probable source of the hemorrhage was small mesenteric branches. An angiography of the aorta and its branches revealed no active hemorrhage (). The probable source of the hemorrhage was small mesenteric branches. An angiography of the aorta and its branches revealed no active hemorrhage (<xref rid="10-1055-s-0034-1395491-i140049-3" ref-type="fig">Fig. 3</xref>). A competent artery of Adamkiewicz was localized at T11 on the left side. Stenosis of the celiac trunk with an aneurysm distally was confirmed. An urgent magnetic resonance imaging (MRI) of the spine showed an intraspinal, intradural hemorrhage, extending from the C1 to L1. There was also an epidural component of blood. Compression of the spinal cord at the midthoracic level was observed (). A competent artery of Adamkiewicz was localized at T11 on the left side. Stenosis of the celiac trunk with an aneurysm distally was confirmed. An urgent magnetic resonance imaging (MRI) of the spine showed an intraspinal, intradural hemorrhage, extending from the C1 to L1. There was also an epidural component of blood. Compression of the spinal cord at the midthoracic level was observed (<xref rid="10-1055-s-0034-1395491-i140049-4" ref-type="fig">Fig. 4</xref>).).']} | Concomitant Intraspinal and Retroperitoneal Hemorrhage Caused by an Aneurysm on the Celiac Artery: A Case Report | [
"spinal hemorrhage",
"coumarins",
"celiac trunk aneurysm",
"paresis",
"abdominal hemorrhage"
] | J Neurol Surg Rep | 1437030000 | Background Although germ cell tumors and pineal cell tumors account for most of the histologic tumor subtypes, > 17 different tumors can arise in this location. We report a rare case of a low-grade oligodendroglioma that arose in the pineal region. Clinical Presentation A young woman complaining of a headache underwent magnetic resonance imaging that showed a mass in the pineal region and mild hydrocephalus. A ventriculoperitoneal shunt was performed followed by a near-total tumor removal, due to tumor invasion of the tectal plate and thalamus. The histologic examination confirmed the diagnosis of a low-grade oligodendroglioma. The patient then underwent chemotherapy and radiotherapy as adjuvant therapies. Conclusion Although the pineal region is a common place for a large number of tumoral lesions, low-grade oligodendrogliomas are extremely rare in this location. This case is only the second account of a benign oligodendroglioma of the pineal region reported in the literature. | [] | other | PMC4520959 | null | 17 | [
"{'Citation': 'Gaillard F, Jones J. Masses of the pineal region: clinical presentation and radiographic features. Postgrad Med J. 2010;86(1020):597–607.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20971711'}}}",
"{'Citation': 'Regis J Bouillot P Rouby-Volot F Figarella-Branger D Dufour H Peragut J C Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases Neurosurgery 1996395907–912.; discussion 912–914', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8905744'}}}",
"{'Citation': 'Sano K. Baltimore, MD: Williams &Wilkins; 1987. Pineal Region and Posterior Third Ventricular Tumors: A Surgical Overview.'}",
"{'Citation': 'Das S, Chandler J P, Pollack A. et al.Oligodendroglioma of the pineal region. Case report. J Neurosurg. 2006;105(3):461–464.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16961143'}}}",
"{'Citation': 'Levidou G, Korkolopoulou P, Agrogiannis G, Paidakakos N, Bouramas D, Patsouris E. Low-grade oligodendroglioma of the pineal gland: a case report and review of the literature. Diagn Pathol. 2010;5:59.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2949720'}, {'@IdType': 'pubmed', '#text': '20849631'}]}}",
"{'Citation': 'Engelhard H H Stelea A Cochran E J Oligodendroglioma: pathology and molecular biology Surg Neurol 2002582111–117.; discussion 117', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12453646'}}}",
"{'Citation': 'Baehring J M. An update on oligodendroglial neoplasms. Curr Opin Neurol. 2005;18(6):639–644.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16280674'}}}",
"{'Citation': 'Chin H W, Hazel J J, Kim T H, Webster J H. Oligodendrogliomas. I. A clinical study of cerebral oligodendrogliomas. Cancer. 1980;45(6):1458–1466.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '6766802'}}}",
"{'Citation': 'Gan H K, Rosenthal M A, Dowling A. et al.A phase II trial of primary temozolomide in patients with grade III oligodendroglial brain tumors. Neuro-oncol. 2010;12(5):500–507.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2940620'}, {'@IdType': 'pubmed', '#text': '20406900'}]}}",
"{'Citation': 'Reis Filho J S, Netto M R, Sluminsky B G. et al.Oligodendroglioma: a pathological and clinical study of 15 cases [in Portuguese] Arq Neuropsiquiatr. 1999;57(2A):249–254.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10412525'}}}",
"{'Citation': 'Van den Bent M J, Reni M, Gatta G, Vecht C. Oligodendroglioma. Crit Rev Oncol Hematol. 2008;66(3):262–272.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18272388'}}}",
"{'Citation': 'Krueger E G, Krupp G. Oligodendrogliomas arising from structures of the posterior fossa. Neurology. 1952;2(6):461–470.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '13002594'}}}",
"{'Citation': 'Packer R J, Sutton L N, Rorke L B. et al.Oligodendroglioma of the posterior fossa in childhood. Cancer. 1985;56(1):195–199.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '4005789'}}}",
"{'Citation': 'Alvarez J A, Cohen M L, Hlavin M L. Primary intrinsic brainstem oligodendroglioma in an adult. Case report and review of the literature. J Neurosurg. 1996;85(6):1165–1169.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8929513'}}}",
"{'Citation': 'Lapras C, Bognar L, Turjman F. et al.Tectal plate gliomas. Part I: Microsurgery of the tectal plate gliomas. Acta Neurochir (Wien) 1994;126(2–4):76–83.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8042559'}}}",
"{'Citation': 'Berger M S, Deliganis A V, Dobbins J, Keles G E. The effect of extent of resection on recurrence in patients with low grade cerebral hemisphere gliomas. Cancer. 1994;74(6):1784–1791.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8082081'}}}",
"{'Citation': 'Kumar P, Tatke M, Sharma A, Singh D. Histological analysis of lesions of the pineal region: A retrospective study of 12 years. Pathology - Research and Practice. 2006;202:85–92.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16413691'}}}"
] | J Neurol Surg Rep. 2015 Jul 16; 76(1):e28-e31 | NO-CC CODE |
|
Two-year postoperative sagittal postcontrast magnetic resonance imaging after radiotherapy and chemotherapy demonstrated no visible residual tumor. | 10-1055-s-0034-1396653-i140036-4 | 7 | 6085187a6adc2bd59ed534e4e89704374be23d9638dff3a3785f7108b05eecba | 10-1055-s-0034-1396653-i140036-4.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
800
] | [{'image_id': '10-1055-s-0034-1396653-i140036-1', 'image_file_name': '10-1055-s-0034-1396653-i140036-1.jpg', 'image_path': '../data/media_files/PMC4520971/10-1055-s-0034-1396653-i140036-1.jpg', 'caption': 'Preoperative midline sagittal postgadolinium magnetic resonance imaging presented a heterogeneous solid lesion in the pineal region extending to the posterior part of the third ventricle.', 'hash': '2fac10279484c0a9bc6e25ddcae5f8ef55459703ee7af5472ea70e6b45cc84a3'}, {'image_id': '10-1055-s-0034-1396653-i140036-3', 'image_file_name': '10-1055-s-0034-1396653-i140036-3.jpg', 'image_path': '../data/media_files/PMC4520971/10-1055-s-0034-1396653-i140036-3.jpg', 'caption': 'Early postoperative midline sagittal postcontrast magnetic resonance imaging showing a small residual tumor in the tectal plate region.', 'hash': '97e7a52c386a4a091a649e55e6f5543e552819623f1632d06aa4c76af224e114'}, {'image_id': '10-1055-s-0034-1396653-i140036-4', 'image_file_name': '10-1055-s-0034-1396653-i140036-4.jpg', 'image_path': '../data/media_files/PMC4520971/10-1055-s-0034-1396653-i140036-4.jpg', 'caption': 'Two-year postoperative sagittal postcontrast magnetic resonance imaging after radiotherapy and chemotherapy demonstrated no visible residual tumor.', 'hash': '6085187a6adc2bd59ed534e4e89704374be23d9638dff3a3785f7108b05eecba'}, {'image_id': '10-1055-s-0034-1396653-i140036-2', 'image_file_name': '10-1055-s-0034-1396653-i140036-2.jpg', 'image_path': '../data/media_files/PMC4520971/10-1055-s-0034-1396653-i140036-2.jpg', 'caption': 'Microscopic sections of tumor showing round neoplastic cells with perinuclear haloes and a centrally located round nucleus with open chromatin.', 'hash': 'b7b116c5706ebb990bfc633890032724fad755a1002452d58067197f31745be3'}] | {'10-1055-s-0034-1396653-i140036-1': ['A 22-year-old woman was admitted to the hospital with a 1-month history of progressive headache. Her past medical history revealed a congenital deafness secondary to rubella. Her neurologic examination showed bilateral deafness, upward gaze palsy, mydriasis, convergence impairment, and no pupil light reaction (complete Parinaud syndrome). She underwent brain magnetic resonance imaging (MRI) that disclosed a heterogeneous, irregularly enhancing solid lesion in the region of the pineal gland, with compression of the cerebral aqueduct (<xref rid="10-1055-s-0034-1396653-i140036-1" ref-type="fig">Fig. 1</xref>). Mild ventriculomegaly was also noted. Imaging of the remainder neuroaxis revealed no other lesions, and the search for alfa-fetoprotein and β-human chorionic gonadotropin in the cerebrospinal fluid and blood was negative.). Mild ventriculomegaly was also noted. Imaging of the remainder neuroaxis revealed no other lesions, and the search for alfa-fetoprotein and β-human chorionic gonadotropin in the cerebrospinal fluid and blood was negative.'], '10-1055-s-0034-1396653-i140036-2': ['A microscopic examination of hematoxylin-and-eosin stained sections showed round neoplastic cells with characteristic perinuclear haloes and centrally located round nuclei with open chromatin and without any pleomorphism or necrosis (<xref rid="10-1055-s-0034-1396653-i140036-2" ref-type="fig">Fig. 2</xref>). An immunohistochemical analysis showed that the neoplastic cells were positive for synaptophysin, neurofilaments, and glial fibrillary acidic protein. The Ki-67 proliferation index was low (1% of neoplastic cells). The fluorescence in situ hybridization analysis (chromosome arms 1p and 19q) showed 1p and 19q deletion. Therefore, a diagnosis of OD, grade II, was assigned.). An immunohistochemical analysis showed that the neoplastic cells were positive for synaptophysin, neurofilaments, and glial fibrillary acidic protein. The Ki-67 proliferation index was low (1% of neoplastic cells). The fluorescence in situ hybridization analysis (chromosome arms 1p and 19q) showed 1p and 19q deletion. Therefore, a diagnosis of OD, grade II, was assigned.'], '10-1055-s-0034-1396653-i140036-3': ['The patient had an uneventful postoperative course but persisted with upward gaze palsy, although her pupillary light reflex improved. The postoperative MRI showed a small residual tumor in the tectorial region (<xref rid="10-1055-s-0034-1396653-i140036-3" ref-type="fig">Fig. 3</xref>). The patient was discharged home on postoperative day 5. Because of the incomplete resection and the infiltrative tumor pattern observed during the surgical procedure, the patient underwent fractionated external-beam radiation therapy to the tumor bed (50.4\u2009Gy over 28 fractions), with a concurrent course of temozolomide(TMZ) (75 mg/m). The patient was discharged home on postoperative day 5. Because of the incomplete resection and the infiltrative tumor pattern observed during the surgical procedure, the patient underwent fractionated external-beam radiation therapy to the tumor bed (50.4\u2009Gy over 28 fractions), with a concurrent course of temozolomide(TMZ) (75 mg/m2/day) followed by five cycles of TMZ(150 mg/m2/day for 5 days every 28 days) as an adjuvant therapy. A MRI obtained at her 24-month follow-up demonstrated no evidence of disease. The patient remained with an upward gaze palsy (<xref rid="10-1055-s-0034-1396653-i140036-4" ref-type="fig">Fig. 4</xref>).).']} | Low-Grade Oligodendroglioma of the Pineal Region: Case Report | [
"oligodendroglioma",
"pineal region",
"tectal plate",
"pineal gland"
] | J Neurol Surg Rep | 1436079600 | Objective Hemorrhage control in skull base surgery is critical but hindered by the lack of instruments suitable for coagulating structural curves and corners. The main impediment is that most of the instruments currently used are right-angled and unsuitable because anatomical and pathologic structures are three-dimensional objects having complex curves and corners. In this article, we present a solution: the use of angled bipolar microforceps having a range of small diameters and angles for dissection and coagulation. Methods Utilizing modern design software and up-to-date synthetic and metallic materials, a variety of nonstick bipolar microforceps with different angles and very fine tips (0.2-1.2 mm) were designed and constructed for use on different anatomical and pathologic curves. The tips of the forceps were made very fine to improve coagulation precision as well as to improve microdissection dexterity. The blades were made long and thin to improve visibility during coagulation and dissection procedures. As a result, these multi-size, multiangle micro instruments can be used not only for coagulation but also for microdissection or tumor removal in most anatomical areas accessed during the course of skull base surgery Results The research, design, and construction of a new bipolar microforceps with different angles and sizes represents a technical innovation that can lead to improved surgical outcomes. Conclusion The new micro-instruments enhance the quality and quantity of tumor and tissue resection and dissection in skull base surgery and open the possibility of new surgical approaches to microscopic tumor resection and hemorrhage coagulation in the anatomical areas of the skull base. | [] | other | PMC4520971 | null | 10 | [
"{'Citation': 'Schick U. Meningiomas involving the sphenoid wing outcome after microsurgical treatment—a clinical review of 73 cases. Cent Eur Neurosurg. 2010;71(4):198.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20737359'}}}",
"{'Citation': 'Schick U Hassler W Decompression of endocrine orbitopathy via an extended extradural pterional approach Acta Neurochir (Wien) 20051472143–149.; discussion 149', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15480832'}}}",
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"{'Citation': 'Schick U, Hassler W. Surgical management of tuberculum sellae meningiomas: involvement of the optic canal and visual outcome. J Neurol Neurosurg Psychiatry. 2005;76(7):977–983.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC1739719'}, {'@IdType': 'pubmed', '#text': '15965205'}]}}",
"{'Citation': 'Shrivastava R K, Sen C, Costantino P D, Della Rocca R. Sphenoorbital meningiomas: surgical limitations and lessons learned in their long-term management. J Neurosurg. 2005;103(3):491–497.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16235682'}}}",
"{'Citation': 'Safavi-Abbasi S, Zabramski J M, Deshmukh P. et al.Moving toward the petroclival region: a model for quantitative and anatomical analysis of tumor shift. J Neurosurg. 2007;107(4):797–804.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17937226'}}}",
"{'Citation': 'Ichimura S, Kawase T, Onozuka S, Yoshida K, Ohira T. Four subtypes of petroclival meningiomas: differences in symptoms and operative findings using the anterior transpetrosal approach. Acta Neurochir (Wien) 2008;150(7):637–645.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18548192'}}}",
"{'Citation': 'Ramina R, Neto M C, Fernandes Y B, Aguiar P H, de Meneses M S, Torres L F. Meningiomas of the jugular foramen. Neurosurg Rev. 2006;29(1):55–60.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16195869'}}}",
"{'Citation': 'Samii M, Tatagiba M, Carvalho G A. Resection of large petroclival meningiomas by the simple retrosigmoid route. J Clin Neurosci. 1999;6(1):27–30.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10833567'}}}",
"{'Citation': 'Komatsu F, Komatsu M, Di Ieva A, Tschabitscher M. Endoscopic approaches to the trigeminal nerve and clinical consideration for trigeminal schwannomas: a cadaveric study. J Neurosurg. 2012;117(4):690–696.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22900839'}}}"
] | J Neurol Surg Rep. 2015 Jul 5; 76(1):e55-e58 | NO-CC CODE |
|
(A) Coronal view of status postfrontal craniectomy. Right anterior ethmoidal air cells opacification (arrowhead) with fracture of ethmoid sinus roof (arrow). (B) Sagittal view shows fracture at the ethmoidofrontal junction (arrow). | 10-1055-s-0034-1387194-i140039-4 | 7 | 8fb2d79aaaf0789d3d7ebd64372308f5e0a5e93ff3aa5d7dc19e1d96db1fb4de | 10-1055-s-0034-1387194-i140039-4.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
381
] | [{'image_id': '10-1055-s-0034-1387194-i140039-3', 'image_file_name': '10-1055-s-0034-1387194-i140039-3.jpg', 'image_path': '../data/media_files/PMC4520984/10-1055-s-0034-1387194-i140039-3.jpg', 'caption': '(A) Coronal head computed tomography (CT) shows the skull base fracture (arrow). (B) Sagittal view of head CT shows bullet entry in the forehead through the anterior and posterior walls of the right frontal sinus (arrow).', 'hash': 'a64f9e1e6f0aef32f84772e133dfeba7f0a650db1340a91a1a280eb59af02bc1'}, {'image_id': '10-1055-s-0034-1387194-i140039-4', 'image_file_name': '10-1055-s-0034-1387194-i140039-4.jpg', 'image_path': '../data/media_files/PMC4520984/10-1055-s-0034-1387194-i140039-4.jpg', 'caption': '(A) Coronal view of status postfrontal craniectomy. Right anterior ethmoidal air cells opacification (arrowhead) with fracture of ethmoid sinus roof (arrow). (B) Sagittal view shows fracture at the ethmoidofrontal junction (arrow).', 'hash': '8fb2d79aaaf0789d3d7ebd64372308f5e0a5e93ff3aa5d7dc19e1d96db1fb4de'}, {'image_id': '10-1055-s-0034-1387194-i140039-2', 'image_file_name': '10-1055-s-0034-1387194-i140039-2.jpg', 'image_path': '../data/media_files/PMC4520984/10-1055-s-0034-1387194-i140039-2.jpg', 'caption': '(A) Sagittal magnetic resonance T1 fluid-attenuated inversion recovery scan shows postoperative result of frontal sinus obliteration and frontal sinus encephalocele repair. Bilateral frontal cortical and subcortical encephalomalacia from sequela from gunshot wound injury (arrow, A and B). (B) Residual pneumatization of the left frontal sinus (arrowhead, A and B). No evidence of frontal sinus mucocele formation.', 'hash': 'c07ec91ab16f3e5fd0afc97e0f6bd28cfc0850aecd23def93ae1fce4ee30f980'}, {'image_id': '10-1055-s-0034-1387194-i140039-1', 'image_file_name': '10-1055-s-0034-1387194-i140039-1.jpg', 'image_path': '../data/media_files/PMC4520984/10-1055-s-0034-1387194-i140039-1.jpg', 'caption': '(A) Noncontrast axial computed tomography consistent with a gunshot wound with entry point at the left parasagittal midline hard plate (white arrow). (B) Fracture of the inner table of both frontal sinuses with multiple fragments within the frontal sinuses and along the interhemispheric fissure (white arrow). (C) The trajectory coursed cranially through the left nasal cavity, left ethmoid air cells, left frontal lobe, and exited through the left frontal bone. (D) Posterior intracranial view shows missile trajectory entering through the skull base and exiting through the left frontal bone (arrow).', 'hash': 'c16e44503fe386299c5a900014af9cb38486bbca6ec58340ff9fc22a183baa76'}] | {'10-1055-s-0034-1387194-i140039-1': ['A 16-year-old young man with a history of a self-inflicted gunshot wound with point of entry through the mouth with a 3-cm exit wound on top of the head. He had copious bleeding from the mouth and nose upon entry. Acute trauma life support protocol was undertaken. No previous significant past medical history was reported. <xref rid="10-1055-s-0034-1387194-i140039-1" ref-type="fig">Fig. 1</xref> shows the preoperative images. shows the preoperative images.'], '10-1055-s-0034-1387194-i140039-2': ['To date the patient is without any complaints of clear rhinorrhea or a salty taste sensation. Nasal endoscopy shows a bilateral patent frontal sinus recess with no evidence of obstruction or drainage. Postoperative MRI shows complete frontal sinus obliteration (<xref rid="10-1055-s-0034-1387194-i140039-2" ref-type="fig">Fig. 2</xref>).).'], '10-1055-s-0034-1387194-i140039-3': ['The bullet involved the frontal sinus, the posterior ethmoid, nasal septum, right sphenoid sinus, and medial pterygoid plate with a major bullet fragment lodged into the right, at C2-C3 vertebral level, without lesions of the cervical spine. Internal carotid artery injury was excluded (<xref rid="10-1055-s-0034-1387194-i140039-3" ref-type="fig">Fig. 3</xref>).).'], '10-1055-s-0034-1387194-i140039-4': ['One month after discharge, the patient was complaining of right-sided clear rhinorrhea, with no salty taste sensation in her mouth. Postfrontal craniectomy CT was done, and the patient was scheduled for endoscopic CSF leak repair (<xref rid="10-1055-s-0034-1387194-i140039-4" ref-type="fig">Fig. 4</xref>).).']} | Endoscopic Repair of Frontal Sinus Cerebrospinal Fluid Leaks after Firearm Injuries: Report of Two Cases | [
"frontal sinus",
"skull base",
"cerebrospinal fluid leak",
"gunshot wounds"
] | J Neurol Surg Rep | 1437894000 | Objectives Complete removal of infiltrated bone is required to achieve a Simpson Grade 1 meningioma resection. Reconstruction of the resulting bone defect is typically achieved with a nonnative implant that can result in poor cosmesis, foreign body reaction, or infection. Extracorporeal irradiation and reimplantation of tumorous bone has been used for limb-sparing surgery with excellent results, but this treatment option is not routinely considered in meningioma surgery. We present a case of anterior fossa meningioma with tumorous overlying calvarium that was successfully managed with intraoperative extracorporeal irradiation and reimplantation. Design, Setting, and Participant A 37-year-old woman with persistent chronic headaches was found to have an anterior skull base meningioma with extension into the forehead frontal bone. Concurrently with mass resection, the bone flap was irradiated intraoperatively with 120 Gy. After resection of the tumor, the bone flap was replaced in its native position. Main Outcome Measures and Results Twenty-nine months postoperatively, the patient had an excellent cosmetic outcome with no radiographic evidence of tumor recurrence or significant bone flap resorption. Conclusion Intraoperative extracorporeal irradiation of tumorous calvaria during meningioma surgery is an effective, logistically feasible treatment option to achieve local tumor control and excellent cosmetic outcome. | [] | other | PMC4520984 | null | 31 | [
"{'Citation': 'Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957;20(1):22–39.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC497230'}, {'@IdType': 'pubmed', '#text': '13406590'}]}}",
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] | J Neurol Surg Rep. 2015 Jul 26; 76(1):e8-e12 | NO-CC CODE |
|
Postoperative magnetic resonance imaging. (A and C) T1-weighted images after intravenous contrast and (B) T2-weighted image depicting complete tumor regression with no residual gadolinum enhancement. | 10-1055-s-0035-1549310-i140055-4 | 7 | b768022db3c85513dd58502a03f7b81b8694c1e2a4324d35b25949a969a609c3 | 10-1055-s-0035-1549310-i140055-4.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
257
] | [{'image_id': '10-1055-s-0035-1549310-i140055-1', 'image_file_name': '10-1055-s-0035-1549310-i140055-1.jpg', 'image_path': '../data/media_files/PMC4520996/10-1055-s-0035-1549310-i140055-1.jpg', 'caption': 'Preoperative magnetic resonance imaging. (A) T2-weighted image depicts a 1.8\u2009×\u20091.2 cm hypointense filamentous spreading suprasellar mass lesion above the optic chiasm. (B and C) T1-weighted imaging after intravenous gadolinium: inhomogeneous contrast enhancement with contact of the lesion to the pituitary stalk.', 'hash': 'eed13b36061ac4d88c6f9023ea60727762592cac1e4af93b789ab2cf473b6403'}, {'image_id': '10-1055-s-0035-1549310-i140055-2', 'image_file_name': '10-1055-s-0035-1549310-i140055-2.jpg', 'image_path': '../data/media_files/PMC4520996/10-1055-s-0035-1549310-i140055-2.jpg', 'caption': 'Intraoperative aspect. (A) Suprasellar mass lesion, optic nerve (asterisk) with arachnoid, and curly flower-like lesion (plus sign) arising from the lamina terminalis (number sign). (B) Opening of the arachnoid mater. (C) Aspect after repeated biopsy.', 'hash': 'd98d726f52b52bd66ebff9eb5ac6f6c5b511ea66f6ab0fd6c51627d8b193d339'}, {'image_id': '10-1055-s-0035-1549310-i140055-3', 'image_file_name': '10-1055-s-0035-1549310-i140055-3.jpg', 'image_path': '../data/media_files/PMC4520996/10-1055-s-0035-1549310-i140055-3.jpg', 'caption': 'Microphotographs of the histopathologic specimen stained with hematoxylin and eosin. (A) Overview, original magnification ×10. (B) Noncaseating epithelioid cell granulomas (asterisk) and multinuclear giant cells (number sign); original magnification ×20.', 'hash': '529deee9e7a03d09197f3c79eccfebd495ddcc976271d43307ac1ccf2f018582'}, {'image_id': '10-1055-s-0035-1549310-i140055-4', 'image_file_name': '10-1055-s-0035-1549310-i140055-4.jpg', 'image_path': '../data/media_files/PMC4520996/10-1055-s-0035-1549310-i140055-4.jpg', 'caption': 'Postoperative magnetic resonance imaging. (A and C) T1-weighted images after intravenous contrast and (B) T2-weighted image depicting complete tumor regression with no residual gadolinum enhancement.', 'hash': 'b768022db3c85513dd58502a03f7b81b8694c1e2a4324d35b25949a969a609c3'}] | {'10-1055-s-0035-1549310-i140055-1': ['T2-weighted cranial magnetic resonance imaging (MRI) images revealed a supra- and infra-chiasmatic pre-thalamic mass lesion 1\u2009×\u20091.4\u2009×\u20091.4 cm in diameter, extending from the lamina terminalis into the third ventricle. The lesion appeared solid, fuzzy, and T2-hyperintens. No leptomeningeal involvement was noted. The inhomogeneous wall stretched filamentous to the surrounding tissue. After administration of intravenous gadolinium contrast, a strong signal enhancement was noted (<xref rid="10-1055-s-0035-1549310-i140055-1" ref-type="fig">Fig. 1</xref>).).'], '10-1055-s-0035-1549310-i140055-2': ['Based on clinical and imaging findings, microsurgery was initiated to establish the diagnosis based on histopathology and perform a tumor resection if feasible. Surgery was performed using a subfrontal approach. After a subdural cisternostomy, the optic nerve and chiasm were exposed. The arachnoid layer covering the lamina terminalis was carefully dissected, freeing a curly flower-like exophytic lesion. The lesion was excavated toward the third ventricle. Multiple specimens were sent for intrasurgical frozen section. Immediate pathology suggested a necrotizing epithelioid cell tumor indicative of chronic inflammation. Thus the surgical exploration was confined at this stage (<xref rid="10-1055-s-0035-1549310-i140055-2" ref-type="fig">Fig. 2</xref>).).'], '10-1055-s-0035-1549310-i140055-3': ['Definite histology proved epithelioid cell granulomas and multinucleated giant cells with surrounding lymphocytes. Occasional central necroses without caseation were noted. Granulomas were rich in fibrous tissue and reticulin. PAS and Ziehl-Neelsen staining were negative. The polymerase chain reaction remained negative for mycobacteria (<xref rid="10-1055-s-0035-1549310-i140055-3" ref-type="fig">Fig. 3</xref>).).'], '10-1055-s-0035-1549310-i140055-4': ['In MRI scans 3 months after admission the preexisting mass lesion had regressed completely. Only the pituitary stalk showed a residual, limited focal contrast enhancement in T1-weighted images after gadolinium administration (<xref rid="10-1055-s-0035-1549310-i140055-4" ref-type="fig">Fig. 4</xref>).).']} | A Rare Case of Isolated Cerebral Sarcoidosis Presenting as Suprasellar Mass Lesion with Salt-Wasting Hypopituitarism | [
"neurosarcoidosis",
"intracranial mass lesion",
"salt-wasting hypopituitarism",
"diabetes insipidus"
] | J Neurol Surg Rep | 1437980400 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'Since the identification of the first case of infection with the Middle East respiratory syndrome corona virus (MERS-CoV) in Saudi Arabia in June 2012, the number of laboratory-confirmed cases has exceeded 941 cases globally, of which 347 died. The disease presents as severe respiratory infection often with shock, acute kidney injury, and coagulopathy. Recently, we observed three cases who presented with neurologic symptoms. These are so far the first reported cases of neurologic injury associated with MERS-CoV infection.'}, {'@Label': 'METHODS', '@NlmCategory': 'METHODS', '#text': 'Data was retrospectively collected from three patients admitted with MERS-CoV infection to Intensive Care unit (ICU) at King Abdulaziz Medical City, Riyadh. They were managed separately in three different wards prior to their admission to ICU.'}, {'@Label': 'FINDING', '@NlmCategory': 'RESULTS', '#text': 'The three patients presented with severe neurologic syndrome which included altered level of consciousness ranging from confusion to coma, ataxia, and focal motor deficit. Brain MRI revealed striking changes characterized by widespread, bilateral hyperintense lesions on T2-weighted imaging within the white matter and subcortical areas of the frontal, temporal, and parietal lobes, the basal ganglia, and corpus callosum. None of the lesions showed gadolinium enhancement.'}, {'@Label': 'INTERPRETATION', '@NlmCategory': 'CONCLUSIONS', '#text': 'CNS involvement should be considered in patients with MERS-CoV and progressive neurological disease, and further elucidation of the pathophysiology of this virus is needed.'}] | [
"Aged",
"Coronavirus Infections",
"Humans",
"Magnetic Resonance Imaging",
"Male",
"Middle Aged",
"Middle East Respiratory Syndrome Coronavirus",
"Nervous System Diseases",
"Saudi Arabia"
] | other | PMC4520996 | null | 24 | [
"{'Citation': 'Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. New Engl J Med. 2012;367:1814–1820. doi: 10.1056/NEJMoa1211721.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1056/NEJMoa1211721'}, {'@IdType': 'pubmed', '#text': '23075143'}]}}",
"{'Citation': 'Middle East respiratory syndrome coronavirus (MERS-CoV)—update. http://www.who.int/csr/don/26-december-2014-mers/en/. Accessed 15 Jan 2015', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7089369'}, {'@IdType': 'pubmed', '#text': '23793899'}]}}",
"{'Citation': 'The Who Mers-Cov Research G. State of knowledge and data gaps of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in humans. PLoS Curr. 2013; 5.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3828229'}, {'@IdType': 'pubmed', '#text': '24270606'}]}}",
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] | J Neurol Surg Rep. 2015 Jul 27; 76(1):e140-e145 | NO-CC CODE |
|
Sagittal and coronal view magnetic resonance imaging with gadolinium contrast enhancement revealed a sellar mass with suprasellar extension compatible with pituitary adenoma. | 10-1055-s-0035-1551670-i140048-1 | 7 | c0073c6ee0a96dfe9bfb3831222ecccc8c35fc94c5f438a1a8c908ba841d67de | 10-1055-s-0035-1551670-i140048-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
348
] | [{'image_id': '10-1055-s-0035-1551670-i140048-4', 'image_file_name': '10-1055-s-0035-1551670-i140048-4.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-4.jpg', 'caption': '(Left) Intraoperative views showing the radial artery graft in the plastic tube serve as a guideway from the temporal base through the infratemporal fossa down to the neck. (Right) View into the surgical opening of the neck with the proximal anastomosis of the radial artery to the external carotid artery just distal to the carotid bifurcation.', 'hash': '500b863f61249f1d8f98a91d99e00a2f1c30c0d4fc23d5090af13b2bac787c05'}, {'image_id': '10-1055-s-0035-1551670-i140048-3', 'image_file_name': '10-1055-s-0035-1551670-i140048-3.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-3.jpg', 'caption': 'Postoperative magnetic resonance imaging shows complete removal of the pituitary adenoma and clipping of the left internal carotid artery (ICA) aneurysm with slight contrast enhancement of the packing material. The right ICA demonstrates no lesion or pseudoaneurysm.', 'hash': '41dfcd13fb30e9ba05e34841c67faeef2248d38409517de4666e50c4ee188c60'}, {'image_id': '10-1055-s-0035-1551670-i140048-2', 'image_file_name': '10-1055-s-0035-1551670-i140048-2.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-2.jpg', 'caption': '(Left) Angiographic image of right internal carotid artery (ICA) (venous phase) showed only minimal contrast extravasation (arrows). (Right) Angiographic image of left ICA showed ICA bifurcation aneurysm with A1 segment hypoplasia.', 'hash': '1584470bca71b9456cbd95c7bfdaaf8f300686bb288323806fda25cc104a1ba3'}, {'image_id': '10-1055-s-0035-1551670-i140048-5', 'image_file_name': '10-1055-s-0035-1551670-i140048-5.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-5.jpg', 'caption': '(Left) Distal anastomosis radial artery to the supraclinoid internal carotid artery (ICA) with temporary clips on the ICA and radial artery graft. (Right) Removal of the temporary clips demonstrated a good blood flow from the radial graft to the ICA.', 'hash': 'a8e7851f3c3706a43b7a1694e0290f5389f8713f0b8f5f996ddfda2c750ba2f9'}, {'image_id': '10-1055-s-0035-1551670-i140048-6', 'image_file_name': '10-1055-s-0035-1551670-i140048-6.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-6.jpg', 'caption': '(Left) Postoperative magnetic resonance imaging showed right infarction of the anterior choroidal artery territory due to prolong ischemic time during bypass surgery. (Right) Postoperative angiogram showed the distal anastomosis (arrow) with good blood flow to the internal carotid artery.', 'hash': 'f52f9bfb73c01c9171c6f116f43aef9fc19c0a67fbacedf361f98cbc18fd3aca'}, {'image_id': '10-1055-s-0035-1551670-i140048-1', 'image_file_name': '10-1055-s-0035-1551670-i140048-1.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-1.jpg', 'caption': 'Sagittal and coronal view magnetic resonance imaging with gadolinium contrast enhancement revealed a sellar mass with suprasellar extension compatible with pituitary adenoma.', 'hash': 'c0073c6ee0a96dfe9bfb3831222ecccc8c35fc94c5f438a1a8c908ba841d67de'}, {'image_id': '10-1055-s-0035-1551670-i140048-7', 'image_file_name': '10-1055-s-0035-1551670-i140048-7.jpg', 'image_path': '../data/media_files/PMC4520998/10-1055-s-0035-1551670-i140048-7.jpg', 'caption': 'Computed tomography scan after acute neurologic deterioration (7 days after bypass surgery) showed complete infarction of right hemisphere with herniation.', 'hash': 'edf970c3dc25cc03a85c9bfe16a14fcf3519d9f4dff5e91bcc3f32f5ce567cd4'}] | {'10-1055-s-0035-1551670-i140048-1': ['A 78-year-old female patient presented with slowly progressive visual loss and a bitemporal hemianopsia. Magnetic resonance imaging (MRI) revealed a large sellar mass with suprasellar extension compatible with pituitary macroadenoma (<xref rid="10-1055-s-0035-1551670-i140048-1" ref-type="fig">Fig. 1</xref>). Laboratory analysis showed it to be a nonfunctioning adenoma. Microsurgical resection of the pituitary adenoma via a transnasal-transsphenoidal approach under image guidance was performed. During removal of the lateral bony part of the floor of the sella with a Kerrison rongeur, an accidental injury of the right ICA occurred with severe arterial bleeding. The bleeding was stopped immediately by packing with Surgicel, fibrin glue, hemostatic matrix (FloSeal, Baxter, Zurich, Switzerland), and autologous fat. The surgical procedure was stopped without removal of the tumor. Postoperatively, the patient underwent emergency cerebral angiography that showed only minimal extravasation of contrast from the cavernous segment of the right ICA (). Laboratory analysis showed it to be a nonfunctioning adenoma. Microsurgical resection of the pituitary adenoma via a transnasal-transsphenoidal approach under image guidance was performed. During removal of the lateral bony part of the floor of the sella with a Kerrison rongeur, an accidental injury of the right ICA occurred with severe arterial bleeding. The bleeding was stopped immediately by packing with Surgicel, fibrin glue, hemostatic matrix (FloSeal, Baxter, Zurich, Switzerland), and autologous fat. The surgical procedure was stopped without removal of the tumor. Postoperatively, the patient underwent emergency cerebral angiography that showed only minimal extravasation of contrast from the cavernous segment of the right ICA (<xref rid="10-1055-s-0035-1551670-i140048-2" ref-type="fig">Fig. 2</xref>, arrows). Interestingly, angiography also demonstrated an incidental left ICA bifurcation aneurysm (, arrows). Interestingly, angiography also demonstrated an incidental left ICA bifurcation aneurysm (<xref rid="10-1055-s-0035-1551670-i140048-2" ref-type="fig">Fig. 2</xref>) that was not detected at preoperative MRI, and aplasia of the left A1 segment of the anterior cerebral artery. Two days later, when there was no further bleeding from the surgical site, the patient underwent a left pterional approach with removal of the adenoma. At the same time, the unruptured left ICA aneurysm was clipped. During the operation the patient had no bleeding from the right ICA or any epistaxis. The postoperative MRI revealed complete removal of the pituitary adenoma and the absence of residual aneurysm neck () that was not detected at preoperative MRI, and aplasia of the left A1 segment of the anterior cerebral artery. Two days later, when there was no further bleeding from the surgical site, the patient underwent a left pterional approach with removal of the adenoma. At the same time, the unruptured left ICA aneurysm was clipped. During the operation the patient had no bleeding from the right ICA or any epistaxis. The postoperative MRI revealed complete removal of the pituitary adenoma and the absence of residual aneurysm neck (<xref rid="10-1055-s-0035-1551670-i140048-3" ref-type="fig">Fig. 3</xref>).).'], '10-1055-s-0035-1551670-i140048-4': ['Via right pterional craniotomy and opening of the Sylvian fissure, the right ICA, A1 segment of the anterior cerebral artery, and M1 segment of the middle cerebral artery were dissected. A 17-cm-length graft of the radial artery was harvested by the vascular surgeons. In routine fashion the cervical vessels were prepared and the common carotid artery, external carotid artery (ECA), and ICA were exposed. The graft tunnel was planned from the right temporal base, through the infratemporal fossa, to the neck. Using the trajectory planning mode of the navigation system, a small burr hole was drilled in the temporal base. Then a plastic tube (diameter: 7 mm) was used as a path for the radial artery graft. The tube was pushed upward from the cervical approach through the burr hole into the temporal fossa. The radial artery was then inserted into the plastic tube and was applied up from the neck through the plastic tube into the temporal fossa (<xref rid="10-1055-s-0035-1551670-i140048-4" ref-type="fig">Fig. 4</xref>). The plastic tube was then removed.). The plastic tube was then removed.', 'First, the proximal anastomosis was done on the ECA just distal to the cervical carotid bifurcation (<xref rid="10-1055-s-0035-1551670-i140048-4" ref-type="fig">Fig. 4</xref>). In an end-to-side anastomosis, the radial artery was sutured to the ECA. Adequate blood flow in the radial artery was checked under the microscope and with Doppler sonography. Second, the optimal position for the distal anastomosis intracranially was selected. The anatomical situation was complicated due to the calcified proximal ICA, so the segment between the ICA bifurcation and the posterior communicating artery was chosen. Temporary clips were placed distal to the posterior communicating artery and proximal to the ICA bifurcation. Doppler sonography demonstrated a slight cross-flow from the contralateral A1. The choroidal artery was not perfused for 45 minutes during the temporary clipping of the supraclinoid ICA. The temporary clips were removed, and the radial artery bypass demonstrated good flow. Finally, the cervical ICA was ligated just distal to the bifurcation (). In an end-to-side anastomosis, the radial artery was sutured to the ECA. Adequate blood flow in the radial artery was checked under the microscope and with Doppler sonography. Second, the optimal position for the distal anastomosis intracranially was selected. The anatomical situation was complicated due to the calcified proximal ICA, so the segment between the ICA bifurcation and the posterior communicating artery was chosen. Temporary clips were placed distal to the posterior communicating artery and proximal to the ICA bifurcation. Doppler sonography demonstrated a slight cross-flow from the contralateral A1. The choroidal artery was not perfused for 45 minutes during the temporary clipping of the supraclinoid ICA. The temporary clips were removed, and the radial artery bypass demonstrated good flow. Finally, the cervical ICA was ligated just distal to the bifurcation (<xref rid="10-1055-s-0035-1551670-i140048-5" ref-type="fig">Fig. 5</xref>). The intracranial anastomosis was checked with intraoperative Doppler sonography. Adequate blood flow via the radial artery graft through the anastomosis, into the ICA, A1, and M1, and also to the posterior communicating artery was documented.). The intracranial anastomosis was checked with intraoperative Doppler sonography. Adequate blood flow via the radial artery graft through the anastomosis, into the ICA, A1, and M1, and also to the posterior communicating artery was documented.'], '10-1055-s-0035-1551670-i140048-6': ['Postoperative MRI 1 day after the bypass surgery showed an infarction of the right anterior choroidal artery territory due to the long occlusion time. The cerebral angiography confirmed a patent anastomosis and good flow in the right middle cerebral artery and anterior cerebral artery territories (<xref rid="10-1055-s-0035-1551670-i140048-6" ref-type="fig">Fig. 6</xref>). Postoperatively the patient was alert and had an incomplete hemiparesis and was mobilized during the next few days.). Postoperatively the patient was alert and had an incomplete hemiparesis and was mobilized during the next few days.'], '10-1055-s-0035-1551670-i140048-7': ['However, 1\u2009week postoperatively, the patient developed acute neurologic deterioration with right pupil dilatation. A computed tomography scan showed complete infarction of the right cerebral hemisphere (<xref rid="10-1055-s-0035-1551670-i140048-7" ref-type="fig">Fig. 7</xref>), and unfortunately she died 2 days later.), and unfortunately she died 2 days later.']} | Surgical Treatment of Inadvertent Internal Carotid Artery Lesion by Extraintracranial High-flow Bypass. A Case Report and Review of the Literature | [
"internal carotid artery injury",
"extraintracranial bypass",
"transsphenoidal surgery",
"pituitary surgery"
] | J Neurol Surg Rep | 1436943600 | We present a chemical method to selectively tag and enrich thymine modifications, 5-formyluracil (5-fU) and 5-hydroxymethyluracil (5-hmU), found naturally in DNA. Inherent reactivity differences have enabled us to tag 5-fU chemoselectively over its C modification counterpart, 5-formylcytosine (5-fC). We rationalized the enhanced reactivity of 5-fU compared to 5-fC via ab initio quantum mechanical calculations. We exploited this chemical tagging reaction to provide proof of concept for the enrichment of 5-fU containing DNA from a pool that contains 5-fC or no modification. We further demonstrate that 5-hmU can be chemically oxidized to 5-fU, providing a strategy for the enrichment of 5-hmU. These methods will enable the mapping of 5-fU and 5-hmU in genomic DNA, to provide insights into their functional role and dynamics in biology. | [
"Base Sequence",
"DNA",
"Models, Molecular",
"Nucleic Acid Conformation",
"Oligodeoxyribonucleotides",
"Pentoxyl",
"Thymine",
"Uracil"
] | other | PMC4520998 | null | 21 | [
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] | J Neurol Surg Rep. 2015 Jul 15; 76(1):e100-e104 | NO-CC CODE |
|
Subphrenic peritoneal disease. (a) Postgadolinium T1-weighted coronal MRI demonstrates nodular enhancement of bilateral subphrenic peritoneal deposits (arrows). (b) Coronal T2-weighted MRI of the upper abdomen shows a solitary right subphrenic deposit (arrows). | ci11001604 | 7 | 7d9398c84f02b249bea9cf30f16e23da92e5169429f968b9919c466059c598d1 | ci11001604.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
451,
773
] | [{'image_id': 'ci11001601', 'image_file_name': 'ci11001601.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001601.jpg', 'caption': 'Normal mesothelium histological features. (a) Haematoxylin and eosin and (b) calretinin stains show normal mesothelium (arrows).', 'hash': '8c49710c1aee30491b0b319b04a039efcd8c8479544b42f4558131a92488ce04'}, {'image_id': 'ci11001606', 'image_file_name': 'ci11001606.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001606.jpg', 'caption': 'Metastatic ovarian carcinoma with calcified peritoneal deposits on FDG PET/CT. (a) Contrast-enhanced MDCT shows multiple calcified (dashed arrows) and non-calcified (solid arrows) peritoneal deposits. (b) Coronal fused PET/CT demonstrating avid FDG uptake within the calcified and non-calcified deposits.', 'hash': '6607490db9405fa092ce2f71862fb253beee0b5ddf48c9bd28017adcd68556ee'}, {'image_id': 'ci11001608', 'image_file_name': 'ci11001608.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001608.jpg', 'caption': 'Pseudomyxoma peritonei. Axial contrast-enhanced CT shows the typical excessive scalloping of the liver and spleen from intraperitoneal mucin.', 'hash': 'ceaac523d927259376b997d1129c19988152990a0c4721c161b59eb679b68f49'}, {'image_id': 'ci110016015', 'image_file_name': 'ci110016015.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016015.jpg', 'caption': 'Malignant peritoneal mesothelioma. (a) Contrast-enhanced axial CT of the upper abdomen showing homogeneous tumour occupying the right subphrenic space (arrows), displacing adjacent liver parenchyma. (b) Axial images of the lower abdomen and (c) pelvis show an extensive confluent peritoneal mass (arrows) with associated ascites.', 'hash': '5a59e98b62f7f1b82b72ec65eedd5e52aa9abc59da38e32486672f0ceb135139'}, {'image_id': 'ci110016012', 'image_file_name': 'ci110016012.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016012.jpg', 'caption': 'Greater omentum deposit. Axial contrast-enhanced CT shows extensive tumour involvement of the greater omentum (arrows), giving rise to an omental cake secondary to ovarian carcinoma. Note associated ascites and nodularity of the right paracolic peritoneal reflection (arrow heads).', 'hash': '9ac207751e40fcbe5468827037f92a6c286abc38772353be55a73b96668fc16d'}, {'image_id': 'ci11001609', 'image_file_name': 'ci11001609.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001609.jpg', 'caption': 'Subphrenic peritoneal deposit. Contrast-enhanced (a) axial and (b) coronal reformat MDCT showing a focal low attenuation peritoneal deposit (arrowed) from ovarian carcinomatosis.', 'hash': 'a4c9f0adcaac8740dafb7d5d029ba258443eb8e1261e6d6e0d4af6728609dc37'}, {'image_id': 'ci11001607', 'image_file_name': 'ci11001607.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001607.jpg', 'caption': 'Metastatic pancreatic neuroendocrine tumour. Axial contrast-enhanced MDCT shows the typical hypervascular peritoneal deposits from a neuroendocrine tumour (arrows).', 'hash': '35ab0ffae5de109ce01aa0772b5e9e1d24dafa34051bcec53f25b5c374ba1f1d'}, {'image_id': 'ci110016013', 'image_file_name': 'ci110016013.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016013.jpg', 'caption': 'Serosal deposits. (a) Axial contrast-enhanced MDCT shows small bowel serosal deposits from metastatic ovarian carcinoma (arrows). Note involvement of the greater omentum and extensive ascites. In a different case, (b) coronal T2-weighted MRI demonstrates multisegment small bowel serosal deposits (arrows).', 'hash': '065f3eb442634774b3fe6409d725d992fb21fe6bb21b3f163cffd2cc1cae5455'}, {'image_id': 'ci110016014', 'image_file_name': 'ci110016014.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016014.jpg', 'caption': 'Pelvic peritoneal involvement. (a) Sagittal T2-weighted MRI depicting peritoneal thickening and nodularity (arrows). Sagittal T1-weighted fat-saturated MRI (b) before and (c) after intravenous injection of gadolinium demonstrating marked abnormal peritoneal enhancement. Ascitic fluid (F) outlines the pelvic peritoneal spaces.', 'hash': '11de1560b0debd80b62ec901f49659e0bfa4c938e5ccd5aa35f3cd63d73fd871'}, {'image_id': 'ci110016017', 'image_file_name': 'ci110016017.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016017.jpg', 'caption': 'Primary peritoneal lymphoma. Axial contrast-enhanced MDCT images show (a) diffuse confluent mass involving the small bowel mesentery, bowel serosa and greater omentum. (b) and (c) show extensive disease involving the root of the small bowel mesentery and bowel wall. Note associated ascites.', 'hash': '918d2f345f1e8c90c7269f4dd633262a31ae4a17d2dfec4260c3d46bdd8e95e3'}, {'image_id': 'ci110016010', 'image_file_name': 'ci110016010.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016010.jpg', 'caption': 'Ovarian peritoneal carcinomatosis. Contrast-enhanced MDCT showing multiple peritoneal deposits involving the falciform ligament (black arrow) and gastrohepatic ligament (dashed arrows). Note the scalloping capsular splenic deposits (arrow heads) and nodular involvement of the greater omentum (solid white arrows).', 'hash': '71acc7deb26717e13cf8c1e85b5e8d299630708bceeb342456098f5357fb793b'}, {'image_id': 'ci11001603', 'image_file_name': 'ci11001603.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001603.jpg', 'caption': 'Flow of peritoneal fluid. (a) Coronal and (b) sagittal pictorial diagram showing flow of peritoneal fluid (blue arrows) in relation to peritoneal spaces, ligaments, omenta and mesenteries. A, perihepatic and subdiaphragmatic flow; B, flow over the greater omentum; C, flow along the paracolic gutters; D, peritoneal fluid lying within the most dependent peritoneal space (pouch of Douglas); E, flow around gut serosa; F, communication with lesser sac. (Adapted from Amin Z, Reznek RH. Peritoneal metastases. In: Husband JE, Reznek RH, editors. Imaging in oncology. 3rd ed. Informa Healthcare; 2009. p. 1094–114; with permission.)', 'hash': '71f31ce5f446d304a10110e0063ce975c7daa444cd5680d0c32614597ac385d7'}, {'image_id': 'ci11001604', 'image_file_name': 'ci11001604.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001604.jpg', 'caption': 'Subphrenic peritoneal disease. (a) Postgadolinium T1-weighted coronal MRI demonstrates nodular enhancement of bilateral subphrenic peritoneal deposits (arrows). (b) Coronal T2-weighted MRI of the upper abdomen shows a solitary right subphrenic deposit (arrows).', 'hash': '7d9398c84f02b249bea9cf30f16e23da92e5169429f968b9919c466059c598d1'}, {'image_id': 'ci110016011', 'image_file_name': 'ci110016011.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016011.jpg', 'caption': 'Carcinoid tumour. Contrast-enhanced MDCT shows a spiculated soft tissue mass within the small bowel mesentery (arrow). The central calcification and soft tissue projections extending from the mass are typical of the associated desmoplastic reaction.', 'hash': '8f8265da1f41a371140640d904c60728e4d505ecedd99185c95783a9e59ac64e'}, {'image_id': 'ci110016016', 'image_file_name': 'ci110016016.jpg', 'image_path': '../data/media_files/PMC3205758/ci110016016.jpg', 'caption': 'Desmoplastic small round cell tumour. MRI pelvis (a) sagittal T2-weighted and (b) axial T1-weighted images demonstrating a large lobulated peritoneal mass extending into the pelvis (arrows), which shows (c) enhancement after intravenous gadolinium injection (arrows).', 'hash': 'b1af05e8213708b5b575d598bd2dfc4af36cc08cd4bd87af293c15f1bbb22c79'}, {'image_id': 'ci11001605', 'image_file_name': 'ci11001605.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001605.jpg', 'caption': 'Peritoneal lymphoma. FDG PET/CT demonstrates diffuse deposits within the greater omentum (arrows) on (a) unenhanced CT. (b) Axial fused PET/CT and (c) coronal PET images show multiple areas of increased uptake within these and other greater omental deposits, including several retroperitoneal nodes (arrows).', 'hash': '3b6df78492aabeb06e38ba24d124c4a565e3b9a8219a4ed6171bbcdfae142803'}, {'image_id': 'ci11001602', 'image_file_name': 'ci11001602.jpg', 'image_path': '../data/media_files/PMC3205758/ci11001602.jpg', 'caption': 'Subphrenic peritoneal deposit. Contrast-enhanced MDCT demonstrating a right subphrenic deposit (arrows) in (a) axial and (b) coronal planes from metastatic ovarian carcinoma.', 'hash': '06d6c12442c610278d8f8e9699275ad3dc0fbd19098b3e8ae3ad568cbf255099'}] | {'ci11001601': ['Microscopically, the peritoneum consists of a single layer of flat mesothelial cells with an underlying layer of loose connective tissue, separated by a basal lamina. The submesothelial connective tissue layer is composed of collagen, fibroblast-like cells, elastic tissues, arteries, veins and lymphatics (<xref ref-type="fig" rid="ci11001601">Fig. 1</xref>). Mesothelial cells are long, flat and slender, with a high cytoplasm/nucleoli ratio and specialized microvilli on their surface, which are essential in trapping compounds that have lubricant qualities to allow a frictionless environment.\n). Mesothelial cells are long, flat and slender, with a high cytoplasm/nucleoli ratio and specialized microvilli on their surface, which are essential in trapping compounds that have lubricant qualities to allow a frictionless environment.\nFigure 1Normal mesothelium histological features. (a) Haematoxylin and eosin and (b) calretinin stains show normal mesothelium (arrows).'], 'ci11001602': ['Functionally, the peritoneum provides unimpeded mobility of contained visceral organs, but also has absorptive and immunological properties. Circulating peritoneal fluid is preferentially drawn up towards the right subphrenic space where it is absorbed into the thoracic lymphatic system, which explains the frequency of deposits in the right subphrenic region in patients with pelvic malignancy (<xref ref-type="fig" rid="ci11001602">Fig. 2</xref>))[3]. Immunologically, large aggregates of macrophages and lymphocytes can be found within the peritoneum.\nFigure 2Subphrenic peritoneal deposit. Contrast-enhanced MDCT demonstrating a right subphrenic deposit (arrows) in (a) axial and (b) coronal planes from metastatic ovarian carcinoma.'], 'ci11001603': ['The inframesolic compartment is divided into two by the oblique orientation of the small bowel mesentery, where it attaches from the left upper quadrant at the ligament of Trietz to the right iliac fossa at the ileocaecal junction. The larger left inframesocolic space freely communicates with the pelvis, except at the sigmoid mesocolon. The right infracolic space is bound inferiorly by the caecum. Paracolic gutters represent peritoneal recesses lateral to the ascending and descending colon. Although both paracolic spaces freely communicate with the pelvis, it is only the larger right paracolic space that communicates with the right supramesocolic space. Circulating peritoneal fluid is preferentially drawn up the right paracolic gutter as the phrenicocolic ligament impedes flow superiorly from the left paracolic space[5,10]. The flow of peritoneal fluid and its dissemination in relation to the various spaces, ligaments, omenta and mesenteries is shown in <xref ref-type="fig" rid="ci11001603">Fig. 3</xref>.\n.\nFigure 3Flow of peritoneal fluid. (a) Coronal and (b) sagittal pictorial diagram showing flow of peritoneal fluid (blue arrows) in relation to peritoneal spaces, ligaments, omenta and mesenteries. A, perihepatic and subdiaphragmatic flow; B, flow over the greater omentum; C, flow along the paracolic gutters; D, peritoneal fluid lying within the most dependent peritoneal space (pouch of Douglas); E, flow around gut serosa; F, communication with lesser sac. (Adapted from Amin Z, Reznek RH. Peritoneal metastases. In: Husband JE, Reznek RH, editors. Imaging in oncology. 3rd ed. Informa Healthcare; 2009. p. 1094–114; with permission.)'], 'ci11001604': ['The role of MRI in peritoneal malignancy has significantly increased over the last decade, primarily due to improvements in access, technology and protocols. MR imaging is comparable with MDCT in the detection of peritoneal deposits (>1\u2009cm) in many respects[19]. The use of fat suppression, delayed postgadolinium-enhanced sequences and water-soluble enteric contrast agents have allowed detection sensitivities to surpass that of CT[20]. Normal peritoneal enhancement should be equal to or less than that of the liver. Enhancement greater than the liver is abnormal – a sign that is not readily appreciable with postiodinated contrast MDCT[19]. The high contrast conspicuity of fat-suppressed and delayed gadolinium-enhanced MRI makes it the imaging modality of choice in depicting not only subcentimetre deposits (including those <5\u2009mm), but also deposits in anatomically difficult sites (e.g. subphrenic, mesenteric and bowel serosa)[21] (<xref ref-type="fig" rid="ci11001604">Fig. 4</xref>). MRI is the imaging modality of choice in local staging of primary pelvic/gynaecological malignancies due to its superior contrast resolution.\n). MRI is the imaging modality of choice in local staging of primary pelvic/gynaecological malignancies due to its superior contrast resolution.\nFigure 4Subphrenic peritoneal disease. (a) Postgadolinium T1-weighted coronal MRI demonstrates nodular enhancement of bilateral subphrenic peritoneal deposits (arrows). (b) Coronal T2-weighted MRI of the upper abdomen shows a solitary right subphrenic deposit (arrows).'], 'ci11001605': ['Imaging features of peritoneal malignancy on PET shows avid [18F]FDG uptake within well-circumscribed nodules, to diffuse [18F]FDG uptake over peritoneal and serosal surfaces (<xref ref-type="fig" rid="ci11001605">Fig. 5</xref>). Previously occult nodal and extraabdominal disease may also become detectable with PET/CT, potentially changing patient management. However, false-negative results may occur due to small tumour deposits, mucinous tumours (ovarian or colonic) or signet ring gastric cancers not taking up [). Previously occult nodal and extraabdominal disease may also become detectable with PET/CT, potentially changing patient management. However, false-negative results may occur due to small tumour deposits, mucinous tumours (ovarian or colonic) or signet ring gastric cancers not taking up [18F]FDG[31–33]. Non-malignant and inflammatory lesions have been shown to take up [18F]FDG, giving rise to false-positive results[33].\nFigure 5Peritoneal lymphoma. FDG PET/CT demonstrates diffuse deposits within the greater omentum (arrows) on (a) unenhanced CT. (b) Axial fused PET/CT and (c) coronal PET images show multiple areas of increased uptake within these and other greater omental deposits, including several retroperitoneal nodes (arrows).'], 'ci11001606': ['Abnormal enhancement may be the only initial finding to suggest peritoneal infiltration, which is best appreciated with delayed postcontrast MRI[19]. Soft tissue nodules may be solitary or multiple in nature and may be only a few millimetres in size at presentation. Nodules may merge to form plaques or sheets of soft tissue, eventually progressing to form focal or diffuse masses. A combination of nodules, plaques and masses may also coexist in the same patient. Certain tumour types, like mucinous ovarian or colonic peritoneal deposits, may appear as fluid. Carcinoid and certain subtypes of ovarian and gastric cancers are known to produce calcific peritoneal deposits (<xref ref-type="fig" rid="ci11001606">Fig. 6</xref>))[41–44]. Gastroenteropancreatic neuroendocrine tumours typically produce hypervascular peritoneal deposits (<xref ref-type="fig" rid="ci11001607">Fig. 7</xref>). The influence of chemotherapeutic and immune-modulating treatments should also be taken into account when assessing morphology of tumours, with certain tumours becoming cystic, necrotic or calcified on follow-up imaging). The influence of chemotherapeutic and immune-modulating treatments should also be taken into account when assessing morphology of tumours, with certain tumours becoming cystic, necrotic or calcified on follow-up imaging[45].\nFigure 6Metastatic ovarian carcinoma with calcified peritoneal deposits on FDG PET/CT. (a) Contrast-enhanced MDCT shows multiple calcified (dashed arrows) and non-calcified (solid arrows) peritoneal deposits. (b) Coronal fused PET/CT demonstrating avid FDG uptake within the calcified and non-calcified deposits.\nFigure 7Metastatic pancreatic neuroendocrine tumour. Axial contrast-enhanced MDCT shows the typical hypervascular peritoneal deposits from a neuroendocrine tumour (arrows).'], 'ci11001608': ['Ruptured mucinous ovarian or appendiceal tumours may result in pseudomyxoma peritonei, which results from gelatinous tumour deposition, and may have a distinctive imaging appearance (<xref ref-type="fig" rid="ci11001608">Fig. 8</xref>))[50,51].\nFigure 8Pseudomyxoma peritonei. Axial contrast-enhanced CT shows the typical excessive scalloping of the liver and spleen from intraperitoneal mucin.'], 'ci11001609': ['The subphrenic spaces are commonly involved in patients with peritoneal carcinomatosis. This is particularly seen on the right secondary to free flow of fluid into this space from the paracolic gutter. A significant proportion of patients with ovarian cancer have tumour deposits at the subphrenic space (<xref ref-type="fig" rid="ci11001609">Fig. 9</xref>). Disease in these spaces is best detected with contrast-enhanced MRI (). Disease in these spaces is best detected with contrast-enhanced MRI (<xref ref-type="fig" rid="ci11001604">Fig. 4</xref>))[19].\nFigure 9Subphrenic peritoneal deposit. Contrast-enhanced (a) axial and (b) coronal reformat MDCT showing a focal low attenuation peritoneal deposit (arrowed) from ovarian carcinomatosis.'], 'ci110016010': ['This ligament extends from the lesser curve of the stomach to the left lobe of the liver, where it extends into the ligamentum venosum. This serves as a pathway for gastric tumour spread into the periportal space and liver. It also communicates with the hepatoduodenal ligament providing a route for pancreatic cancer to spread into the liver and stomach. Imaging findings vary from diffuse stranding to a large focal mass (<xref ref-type="fig" rid="ci110016010">Fig. 10</xref>).\n).\nFigure 10Ovarian peritoneal carcinomatosis. Contrast-enhanced MDCT showing multiple peritoneal deposits involving the falciform ligament (black arrow) and gastrohepatic ligament (dashed arrows). Note the scalloping capsular splenic deposits (arrow heads) and nodular involvement of the greater omentum (solid white arrows).'], 'ci110016011': ['The small bowel mesentery suspending a large proportion of the small bowel is fixed to the retroperitoneum. It is a fan-shaped shaped structure which extends from the left upper quadrant, attaching at the ligament of Treitz, to the ileocaecal junction[53]. Mesenteric tumour deposition may arise by a number of different modes of spread as described earlier. Flow of ascites pools in the small bowel mesentery, eventually collecting close to the terminal ileum and is often an early detectable site of peritoneal metastases. CT and MR imaging appearances may vary greatly from generalized mistiness of the mesentery to focal nodules or masses producing separation, angulation and/or thickening of the small bowel. A significant proportion of gastrointestinal carcinoid tumours spread to the mesentery giving rise to an enhancing soft tissue mass with surrounding fibrotic radiating linear bands (desmoplastic reaction) (<xref ref-type="fig" rid="ci110016011">Fig. 11</xref>). Gastric, pancreatic, biliary and colon cancer may directly involve leaves of mesentery.\n). Gastric, pancreatic, biliary and colon cancer may directly involve leaves of mesentery.\nFigure 11Carcinoid tumour. Contrast-enhanced MDCT shows a spiculated soft tissue mass within the small bowel mesentery (arrow). The central calcification and soft tissue projections extending from the mass are typical of the associated desmoplastic reaction.'], 'ci110016012': ['Peritoneal metastases are common with imaging features ranging from subtle infiltrative stranding, larger discrete nodules to a diffuse continuous mass, otherwise referred to as omental caking (<xref ref-type="fig" rid="ci110016012">Fig. 12</xref>). A significant proportion of normal appearing omentum on imaging and surgical macroscopic inspection is found to have microscopic peritoneal metastases on histology.\n). A significant proportion of normal appearing omentum on imaging and surgical macroscopic inspection is found to have microscopic peritoneal metastases on histology.\nFigure 12Greater omentum deposit. Axial contrast-enhanced CT shows extensive tumour involvement of the greater omentum (arrows), giving rise to an omental cake secondary to ovarian carcinoma. Note associated ascites and nodularity of the right paracolic peritoneal reflection (arrow heads).'], 'ci110016013': ['Detection of bowel serosal deposits may be difficult, particularly in the absence of adequate bowel distension. Either direct, lymphatic, haematogenous spread or peritoneal seeding can give rise to serosal deposits. Imaging features include diffuse serosal infiltration, focal nodules, segmental mural thickening or a well-defined mass involving both serosa and adjacent mesentery (<xref ref-type="fig" rid="ci110016013">Fig. 13</xref>). Partial or complete bowel obstruction may be the end result.\n). Partial or complete bowel obstruction may be the end result.\nFigure 13Serosal deposits. (a) Axial contrast-enhanced MDCT shows small bowel serosal deposits from metastatic ovarian carcinoma (arrows). Note involvement of the greater omentum and extensive ascites. In a different case, (b) coronal T2-weighted MRI demonstrates multisegment small bowel serosal deposits (arrows).'], 'ci110016014': ['Pelvic organs (bladder, uterus and rectum) are partially covered by the peritoneal reflections, placing these structures in the extraperitoneal space. The resulting uterovesical and rectovaginal spaces (in females) and the rectovesical space (in males) form the most dependent portions of the peritoneal space, allowing fluid accumulation. Primary gynaecological tumours may spread directly into the peritoneal space and subsequently seed. Conversely, tumours from other intraabdominal organs may metastasize and proliferate to the pelvis. Krukenberg tumours are a classic example of this phenomenon, represented by metastatic gastric cancer involvement of the ovaries[54]. Pelvic peritoneal involvement is best assessed with MRI with findings ranging from pelvic sidewall peritoneal enhancement to variable size nodules involving the parametrium (<xref ref-type="fig" rid="ci110016014">Fig. 14</xref>).\n).\nFigure 14Pelvic peritoneal involvement. (a) Sagittal T2-weighted MRI depicting peritoneal thickening and nodularity (arrows). Sagittal T1-weighted fat-saturated MRI (b) before and (c) after intravenous injection of gadolinium demonstrating marked abnormal peritoneal enhancement. Ascitic fluid (F) outlines the pelvic peritoneal spaces.'], 'ci110016015': ['MM has 2 main manifestations: upper abdominal masses and scattered intraabdominal nodules, or a diffuse solid mass (<xref ref-type="fig" rid="ci110016015">Fig. 15</xref>), which involves the mesentery and encases bowel), which involves the mesentery and encases bowel[55,56]. The mesentery may have multiple small irregular densities of sheet-like infiltration progressing to encase mesenteric vessels. Bowel wall thickening and/or irregularity may also be present from direct mesenteric extension or peritoneal implants. The omentum ranges from heterogeneous misty fat to the classic omental cake appearance of irregular thick infiltrative masses of variable sizes.\nFigure 15Malignant peritoneal mesothelioma. (a) Contrast-enhanced axial CT of the upper abdomen showing homogeneous tumour occupying the right subphrenic space (arrows), displacing adjacent liver parenchyma. (b) Axial images of the lower abdomen and (c) pelvis show an extensive confluent peritoneal mass (arrows) with associated ascites.'], 'ci110016016': ['The most characteristic feature of DSRCT is a single or multiple, lobulated, solid, soft tissue mass without an organ of origin (<xref ref-type="fig" rid="ci110016016">Fig. 16</xref>). The masses may be calcified and are located in the peritoneum, omentum, mesentery and retroperitoneum. In 78% of patients, central areas of necrosis were present in the tumours reported in a case series review of 14 patients. In 67%, pelvic and paravesicle tumour was present. Ascites, liver and nodal metastases were also seen). The masses may be calcified and are located in the peritoneum, omentum, mesentery and retroperitoneum. In 78% of patients, central areas of necrosis were present in the tumours reported in a case series review of 14 patients. In 67%, pelvic and paravesicle tumour was present. Ascites, liver and nodal metastases were also seen[63].\nFigure 16Desmoplastic small round cell tumour. MRI pelvis (a) sagittal T2-weighted and (b) axial T1-weighted images demonstrating a large lobulated peritoneal mass extending into the pelvis (arrows), which shows (c) enhancement after intravenous gadolinium injection (arrows).'], 'ci110016017': ['Lymphomatosis may manifest as discrete nodules, large masses or ascites (<xref ref-type="fig" rid="ci110016017">Fig. 17</xref>). PEL typically presents with ascites containing atypical lymphoid cells, which may be of high attenuation due to its high proteinaceous content. Peritoneal lymphomatosis may not be easily differentiated from other causes of peritoneal carcinomatosis and histological confirmation is required). PEL typically presents with ascites containing atypical lymphoid cells, which may be of high attenuation due to its high proteinaceous content. Peritoneal lymphomatosis may not be easily differentiated from other causes of peritoneal carcinomatosis and histological confirmation is required[64,65].\nFigure 17Primary peritoneal lymphoma. Axial contrast-enhanced MDCT images show (a) diffuse confluent mass involving the small bowel mesentery, bowel serosa and greater omentum. (b) and (c) show extensive disease involving the root of the small bowel mesentery and bowel wall. Note associated ascites.']} | CT, MRI and PET imaging in peritoneal malignancy | [
"Peritoneal carcinomatosis",
"CT",
"MRI",
"PET",
"peritoneum",
"peritoneal malignancy"
] | Cancer Imaging | 1314169200 | Imaging plays a vital role in the evaluation of patients with suspected or proven peritoneal malignancy. Nevertheless, despite significant advances in imaging technology and protocols, assessment of peritoneal pathology remains challenging. The combination of complex peritoneal anatomy, an extensive surface area that may host tumour deposits and the considerable overlap of imaging appearances of various peritoneal diseases often makes interpretation difficult. Contrast-enhanced multidetector computed tomography (MDCT) remains the most versatile tool in the imaging of peritoneal malignancy. However, conventional and emerging magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT techniques offer significant advantages over MDCT in detection and surveillance. This article reviews established and new techniques in CT, MRI and PET imaging in both primary and secondary peritoneal malignancies and provides an overview of peritoneal anatomy, function and modes of disease dissemination with illustration of common sites and imaging features of peritoneal malignancy. | [
"Humans",
"Magnetic Resonance Imaging",
"Neoplasm Invasiveness",
"Peritoneal Neoplasms",
"Peritoneum",
"Positron-Emission Tomography",
"Tomography, X-Ray Computed"
] | other | PMC3205758 | null | 66 | [
"{'Citation': 'Meyers MA. Distribution of intra-abdominal malignant seeding: dependency on dynamics of flow of ascitic fluid. Am J Roentgenol Radium Ther Nucl Med. 1973;119:198–206.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '4744725'}}}",
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] | Cancer Imaging. 2011 Aug 24; 11(1):123-139 | NO-CC CODE |
|
Coronal reformatted CT at bone window settings in a 7-year-old boy who had previously been treated for leukaemia with chemotherapy and a bone marrow transplant. Routine follow-up axial CT during a febrile episode had failed to demonstrate the partial vertebral collapse of T4 due to treatment-induced osteopenia. The T4 vertebral collapse is clearly evident on coronal reformatted images (arrow). | ci11002109 | 7 | 7164d1dfaa2adb6b937cea65afdfeab1d86d4b2d71634c46d78384bceed3dcfa | ci11002109.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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"computerized tomography"
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451,
316
] | [{'image_id': 'ci11002103', 'image_file_name': 'ci11002103.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002103.jpg', 'caption': 'Neuroblastoma. Chest radiograph in a 5-month-old boy shows an incidental right paracardiac mass. Close inspection of the right-sided ribs shows some separation posteriorly between the 6th and 7th ribs, and subtle erosion of the inferior surface of the posterior 6th rib medially (arrow). These findings all point to a diagnosis of neuroblastoma, confirmed on biopsy.', 'hash': '24b352c647590d39a4dd2023b96454ea4ab8c49e50a362dd35f8059f11a227c6'}, {'image_id': 'ci11002104', 'image_file_name': 'ci11002104.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002104.jpg', 'caption': 'Pleuropulmonary blastoma. Axial CT through the lower chest at mediastinal window settings after intravenous contrast enhancement in a 2-year-old girl, shows a left basal mass lesion displacing the heart to the right, with some compression of the left atrium and ventricle.', 'hash': '678eda7aae8d7d54234e36ffd59c642a7d3b4394a33b7ef469b97ca1e0253949'}, {'image_id': 'ci11002115', 'image_file_name': 'ci11002115.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002115.jpg', 'caption': 'Neuroblastoma. (a) Axial T2-weighted MRI shows residual tumour at the left paraspinal and intraspinal foramen area (3 smaller arrows). The spleen (larger single arrow) has an unusual position consequent to previous displacement by tumour and later surgical removal of the large infiltrating upper abdominal tumour. (b) Restricted diffusion is seen in the paraspinal tumour mass (black arrow), suggesting high cellularity and residual viable tumour. The spleen also has restricted diffusion which is a normal finding (white arrow).', 'hash': '8534a41ab265c2e5f105583b9ce49383f2880c3cf6f097c12a17e6974998669a'}, {'image_id': 'ci11002112', 'image_file_name': 'ci11002112.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002112.jpg', 'caption': 'Normal thymus on axial CT at mediastinal window settings in a 6-month-old girl. The normal thymus is homogeneous, continuous with the superior heart border and can occupy both upper lung lobes. The normal thymus does not displace the trachea or vessels.', 'hash': '5546916ce5e6394b8b531f77219d5f5166a370d52cdc2f2ebb532a011e75a65a'}, {'image_id': 'ci11002105', 'image_file_name': 'ci11002105.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002105.jpg', 'caption': 'Lung nodule. (a) A chest radiograph demonstrates a small opacity located medially in the left upper zone (arrow). (b) Coronal reformatted CT of the chest at lung window settings demonstrates that this opacity is a well-defined parenchymal nodule in the left upper lobe (arrow).', 'hash': '856b395e55267fb51c9f8f5b268084bac2996efd20cba740972e8a9f33192caf'}, {'image_id': 'ci11002102', 'image_file_name': 'ci11002102.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002102.jpg', 'caption': 'Round pneumonia. Chest radiograph in a 3-year-old girl with infective symptoms demonstrates a well-defined round opacity in the right mid-zone.', 'hash': '93096b6e6986e3b30cd2e03f43bc2503da41df1f8e432be0504d55b2cabfc7a7'}, {'image_id': 'ci11002113', 'image_file_name': 'ci11002113.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002113.jpg', 'caption': 'Multiple lung metastases. Axial CT at lung window settings in a 3-year-old girl demonstrates multiple lung metastases. The child was under investigation for a newly discovered abdominal mass and no chest symptoms.', 'hash': '290f7c491a00f4b5cb8a2afd0150cce2dcb1ac473f5a88c08289e46f5427b86c'}, {'image_id': 'ci11002114', 'image_file_name': 'ci11002114.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002114.jpg', 'caption': 'Small solitary lung nodule. Axial CT at lung window settings in a 5-year-old asymptomatic boy undergoing routine follow-up demonstrates a parenchymal nodule less than 1\u2009cm in the right lower lobe (arrow).', 'hash': '9fda8e566f86741f13fc20989d027ea74289ccd4e89a920ec702e328de7fbf4d'}, {'image_id': 'ci11002117', 'image_file_name': 'ci11002117.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002117.jpg', 'caption': 'Venous malformation (VM). (a) A 2-year-old girl with a heterogeneous gluteal mass lesion on T2-weighted images, which (b) shows a fluid-fluid level (arrow) on a fat-saturated T1-weighted image. The MRI appearances were very suggestive of a VM but on clinical evaluation the mass was a firm hard lump, which is unusual for any vascular malformation. Biopsy confirmed VM with a predominant fibrous component which accounted for the clinical findings.', 'hash': '72f7df7089c10b5ee89049139866fb959088c118ba99eba35181c149b38832e7'}, {'image_id': 'ci11002110', 'image_file_name': 'ci11002110.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002110.jpg', 'caption': 'Rhabdomyosarcoma. (a) Axial CT at bone window settings showing mild lateral displacement of the lateral pterygoid plate, erosion of the medial plate and some lysis also involving the left aspect of the hard palate (arrow). (b) Axial CT at soft tissue window settings in the same patient shows a large nasopharyngeal mass. (c) Axial T2-weighted MRI in a different patient clearly depicts the soft tissue extent of tumour, more obviously demonstrable from the adjacent musculature.', 'hash': '9120e19b716ba0faa381b626a318ae708dff5f19f4d8187c3484d9b6fb0aac7c'}, {'image_id': 'ci11002101', 'image_file_name': 'ci11002101.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002101.jpg', 'caption': 'Normal cardiothymic contour on a chest radiograph in a 6-month-old girl. The normal thymus is homogeneous, continuous with the superior heart border and can occupy both upper lung lobes. The normal thymus does not displace the trachea or vessels.', 'hash': '8789d674fccf85be128b486e10a0c1dd397a21dabfc8182724ba64e8578523cc'}, {'image_id': 'ci11002106', 'image_file_name': 'ci11002106.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002106.jpg', 'caption': 'Langerhans cell histiocytosis. Anterioposteror and lateral films of the right humerus in a 2-year-old girl show an aggressive lytic lesion with prominent periosteal reaction. Biopsy confirmed Langerhans cell histiocytosis.', 'hash': '4b0d635207e2317ae408ab4bd19c648995adc35d96171e024cfd10bb9545383a'}, {'image_id': 'ci11002108', 'image_file_name': 'ci11002108.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002108.jpg', 'caption': 'Wilms tumour. (a) A left renal tumour is clearly discernible as a low attenuating mass after intravenous contrast enhancement in a 6-year-old girl (arrow). (b) The same lesion is not visible on the earlier non-contrast-enhanced image, emphasizing the poor sensitivity of non-contrast CT for abdominal scanning in children (arrow).', 'hash': '0a6033ce1c42adf25e0d6ba52886ddf611577b12851701632b3dd9752d611cd3'}, {'image_id': 'ci11002111', 'image_file_name': 'ci11002111.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002111.jpg', 'caption': 'Hodgkin disease (HD). (a) Axial CT at mediastinal window settings at the level of the aortic arch, 2 months after finishing chemotherapy for HD, shows a small involuted thymus (arrow). (b) Four months later the thymus has enlarged (arrow). This enlargement was initially mistaken for thymic rebound hyperplasia but PET and later biopsy confirmed HD relapse.', 'hash': '27b54d7ead1edf57403004b20c98f35098e890beeea56d34de4d675292778847'}, {'image_id': 'ci11002116', 'image_file_name': 'ci11002116.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002116.jpg', 'caption': 'Wilms tumour. (a) Axial T2-weighted MRI shows a large right renal mass and signal void due to flowing blood in a patent IVC (arrow). US had also confirmed IVC patency, and no tumour thrombus. (b) A pseudothrombus appearance is created from pulsation artefact in the IVC on a fat-suppressed T1-weighted MRI after gadolinium enhancement (arrow).', 'hash': '25a6defb35ff16397661fec9a7850e05f8b88bdb142e0a9c261a656acd39af9b'}, {'image_id': 'ci11002118', 'image_file_name': 'ci11002118.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002118.jpg', 'caption': 'A 5-year-old boy with a history of a sarcoma of the right buttock. At the end of treatment, cross-sectional imaging showed a new mass in the right adrenal. Histology suggested a neuroblastic tumour. Planar images of an [123I]MIBG scan show massive metastatic infiltration within the skeleton. There are two focal areas of increased tracer uptake within the liver, in keeping with two liver metastases (arrows). The primary tumour in the right suprarenal region is not clearly visible. The findings are compatible with stage 4 neuroblastoma, with massive skeletal infiltration and at least two liver metastases. The child died after induction chemotherapy.', 'hash': '335a92072d0383016da64f50c6b6a13966b9d7ba67794ee02d024b789f2b19b2'}, {'image_id': 'ci11002109', 'image_file_name': 'ci11002109.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002109.jpg', 'caption': 'Coronal reformatted CT at bone window settings in a 7-year-old boy who had previously been treated for leukaemia with chemotherapy and a bone marrow transplant. Routine follow-up axial CT during a febrile episode had failed to demonstrate the partial vertebral collapse of T4 due to treatment-induced osteopenia. The T4 vertebral collapse is clearly evident on coronal reformatted images (arrow).', 'hash': '7164d1dfaa2adb6b937cea65afdfeab1d86d4b2d71634c46d78384bceed3dcfa'}, {'image_id': 'ci11002107', 'image_file_name': 'ci11002107.jpg', 'image_path': '../data/media_files/PMC3205763/ci11002107.jpg', 'caption': 'Neuroblastoma. (a) US shows a heavily calcified treated neuroblastoma mass (between callipers) in a 2-year-old boy which could easily be mistaken for bowel gas. (b) Coronal reformatted CT at soft tissue settings in another patient demonstrates the dense calcification that may be seen after chemotherapy in neuroblastoma (arrow), in addition to some residual para-aortic tumour tissue.', 'hash': '5d10274481fdfe76f4cea098f05ce5f764ffa11d17ca47612c99e046c27a6cee'}] | {'ci11002101': ['Confusing the thymus with a mediastinal mass is not an uncommon pitfall in the interpretation of chest radiographs as it is extremely variable in appearance. The normal thymus is homogeneous, continuous with superior heart border and can occupy both upper lung lobes, demonstrating widening on expiration (<xref ref-type="fig" rid="ci11002101">Fig. 1</xref>). The normal thymus does not displace the trachea or vessels.). The normal thymus does not displace the trachea or vessels.'], 'ci11002102': ['External densities such as nipples, dense pre-pubertal breasts and rib deformities can mimic intrapulmonary masses. Round pneumonia in a child with an infective history should not be misinterpreted as a neoplastic lesion (<xref ref-type="fig" rid="ci11002102">Fig. 2</xref>).\n).\nFigure 1Normal cardiothymic contour on a chest radiograph in a 6-month-old girl. The normal thymus is homogeneous, continuous with the superior heart border and can occupy both upper lung lobes. The normal thymus does not displace the trachea or vessels.\nFigure 2Round pneumonia. Chest radiograph in a 3-year-old girl with infective symptoms demonstrates a well-defined round opacity in the right mid-zone.'], 'ci11002103': ['It is uncommon for a malignant mass lesion in the chest to be diagnosed incidentally on a chest radiograph and the differential is much more likely to include a congenital or an inflammatory lesion. The notable exception to this rule is thoracic neuroblastic tumours, which may be incidentally picked up on a radiograph performed for a minor coryzal illness. These tumours are paraspinal and are often associated with posterior rib erosion or separation, which helps increase confidence in that diagnosis (<xref ref-type="fig" rid="ci11002103">Fig. 3</xref>).\n).\nFigure 3Neuroblastoma. Chest radiograph in a 5-month-old boy shows an incidental right paracardiac mass. Close inspection of the right-sided ribs shows some separation posteriorly between the 6th and 7th ribs, and subtle erosion of the inferior surface of the posterior 6th rib medially (arrow). These findings all point to a diagnosis of neuroblastoma, confirmed on biopsy.'], 'ci11002104': ['Primary lung tumours are rare and include bronchogenic tumours, bronchial carcinoids, pleuropulmonary blastomas (<xref ref-type="fig" rid="ci11002104">Fig. 4</xref>))[4] and mesenchymal tumours. Metastatic lung disease is still relatively rare but most commonly from osteosarcoma (where the lung lesions may ossify), Ewings sarcoma, rhabdomyosarcoma, hepatoblastoma and Wilms tumours. The chest radiograph is much less sensitive for pulmonary metastases and tumour assessment compared with CT of the chest (<xref ref-type="fig" rid="ci11002105">Fig. 5</xref>).\n).\nFigure 4Pleuropulmonary blastoma. Axial CT through the lower chest at mediastinal window settings after intravenous contrast enhancement in a 2-year-old girl, shows a left basal mass lesion displacing the heart to the right, with some compression of the left atrium and ventricle.\nFigure 5Lung nodule. (a) A chest radiograph demonstrates a small opacity located medially in the left upper zone (arrow). (b) Coronal reformatted CT of the chest at lung window settings demonstrates that this opacity is a well-defined parenchymal nodule in the left upper lobe (arrow).'], 'ci11002106': ['Radiographs are crucial as the first-line imaging study in the assessment of a suspected bone tumour. Targeted films may be required when a staging bone scan is abnormal suggesting skeletal metastases but overall are less sensitive than bone scintigraphy or MRI. Primary bone tumours in young children are statistically most likely to be from Ewing sarcoma or primitive neuroectodermal tumour (PNET) families, solely on the basis of age. Osteosarcomas classically manifest as tumours around the knee in adolescents. Not all lytic destructive lesions in childhood are malignant. Langerhans cell histiocytosis, occurring most frequently in the first few years of life, is a relatively common benign entity and a great mimic of more serious pathology (<xref ref-type="fig" rid="ci11002106">Fig. 6</xref>). The use of gonadal shielding is recommended in all follow-up paediatric pelvic radiographs but must not be used if the clinicians are specifically concerned about bony metastatic disease to the pelvis which can potentially be obscured by shielding.\n). The use of gonadal shielding is recommended in all follow-up paediatric pelvic radiographs but must not be used if the clinicians are specifically concerned about bony metastatic disease to the pelvis which can potentially be obscured by shielding.\nFigure 6Langerhans cell histiocytosis. Anterioposteror and lateral films of the right humerus in a 2-year-old girl show an aggressive lytic lesion with prominent periosteal reaction. Biopsy confirmed Langerhans cell histiocytosis.'], 'ci11002107': ['Tumour-related pitfalls with US include mistaking a heavily calcified mass for bowel gas (<xref ref-type="fig" rid="ci11002107">Fig. 7</xref>) and confusing the stomach distended with air and food for an abdominal mass. Assuming a cystic lesion in the pelvis is the bladder when in fact the bladder is collapsed or compressed by a large cystic ovarian tumour is a recognized pitfall in paediatric and adolescent US scanning as it is in adults. Paratesticular rhabdomyosarcoma has typically increased vascularity at Doppler assessment and can mimic infection at initial diagnosis) and confusing the stomach distended with air and food for an abdominal mass. Assuming a cystic lesion in the pelvis is the bladder when in fact the bladder is collapsed or compressed by a large cystic ovarian tumour is a recognized pitfall in paediatric and adolescent US scanning as it is in adults. Paratesticular rhabdomyosarcoma has typically increased vascularity at Doppler assessment and can mimic infection at initial diagnosis[10]. Multiple renal veins are difficult to visualize at US and limit the usefulness of US in diagnosing and excluding renal vein thrombus.\nFigure 7Neuroblastoma. (a) US shows a heavily calcified treated neuroblastoma mass (between callipers) in a 2-year-old boy which could easily be mistaken for bowel gas. (b) Coronal reformatted CT at soft tissue settings in another patient demonstrates the dense calcification that may be seen after chemotherapy in neuroblastoma (arrow), in addition to some residual para-aortic tumour tissue.'], 'ci11002108': ['The use of sedation and contrast medium are other important issues. Although scan times are shorter than MRI, sedation or anaesthesia is still often necessary in the young child. Unenhanced CT of the chest and abdomen is usually of very limited usefulness due to lack of mediastinal and intra-abdominal fat and best avoided when evaluating new mass lesions in a paediatric patient (<xref ref-type="fig" rid="ci11002108">Fig. 8</xref>))[11]. The use of contrast medium carries specific, albeit low, risks of extravasation, anaphylaxis and nephrotoxicity. Patient positioning requires careful consideration in those children with mediastinal lymphoma who virtually all present with airway difficulties. Some of these children have learnt to compensate for tracheal compression by remaining upright and forcing them to lie flat for CT examination could have tragic consequences, due to potentially irreversible compression of the trachea by an anterior mediastinal mass. Safer alternatives include scanning in the prone or lateral position or delaying the scan until after a course of steroid therapy.\nFigure 8Wilms tumour. (a) A left renal tumour is clearly discernible as a low attenuating mass after intravenous contrast enhancement in a 6-year-old girl (arrow). (b) The same lesion is not visible on the earlier non-contrast-enhanced image, emphasizing the poor sensitivity of non-contrast CT for abdominal scanning in children (arrow).'], 'ci11002109': ['CT images, unlike MRI, traditionally rely on axial imaging for disease assessment. The ability to reformat images in the coronal and sagittal planes reduces the risk of missing pathology, particularly bone lesions such as collapsed vertebrae (<xref ref-type="fig" rid="ci11002109">Fig. 9</xref>). CT is inferior to MRI in defining the extent of soft tissue masses and, for skull base lesions, a combination of CT and MRI at diagnosis is often needed to fully appreciate disease extent (). CT is inferior to MRI in defining the extent of soft tissue masses and, for skull base lesions, a combination of CT and MRI at diagnosis is often needed to fully appreciate disease extent (<xref ref-type="fig" rid="ci11002110">Fig. 10</xref>).\n).\nFigure 9Coronal reformatted CT at bone window settings in a 7-year-old boy who had previously been treated for leukaemia with chemotherapy and a bone marrow transplant. Routine follow-up axial CT during a febrile episode had failed to demonstrate the partial vertebral collapse of T4 due to treatment-induced osteopenia. The T4 vertebral collapse is clearly evident on coronal reformatted images (arrow).\nFigure 10Rhabdomyosarcoma. (a) Axial CT at bone window settings showing mild lateral displacement of the lateral pterygoid plate, erosion of the medial plate and some lysis also involving the left aspect of the hard palate (arrow). (b) Axial CT at soft tissue window settings in the same patient shows a large nasopharyngeal mass. (c) Axial T2-weighted MRI in a different patient clearly depicts the soft tissue extent of tumour, more obviously demonstrable from the adjacent musculature.'], 'ci11002111': ['Thymic hyperplasia occurs in some younger children after cessation of chemotherapy. Thymic hyperplasia is probably only seen in the first 3–4 months after completing treatment, and thymic enlargement beyond this period, particularly in lymphoma patients, should be regarded as suspicious for tumour relapse (<xref ref-type="fig" rid="ci11002111">Fig. 11</xref>))[13]. The normal and hyperplastic thymus should be homogeneous on all imaging modalities including US, CT and MRI, and a heterogeneous thymus is always abnormal (<xref ref-type="fig" rid="ci11002112">Fig. 12</xref>).\n).\nFigure 11Hodgkin disease (HD). (a) Axial CT at mediastinal window settings at the level of the aortic arch, 2 months after finishing chemotherapy for HD, shows a small involuted thymus (arrow). (b) Four months later the thymus has enlarged (arrow). This enlargement was initially mistaken for thymic rebound hyperplasia but PET and later biopsy confirmed HD relapse.\nFigure 12Normal thymus on axial CT at mediastinal window settings in a 6-month-old girl. The normal thymus is homogeneous, continuous with the superior heart border and can occupy both upper lung lobes. The normal thymus does not displace the trachea or vessels.\nFigure 13Multiple lung metastases. Axial CT at lung window settings in a 3-year-old girl demonstrates multiple lung metastases. The child was under investigation for a newly discovered abdominal mass and no chest symptoms.'], 'ci11002113': ['The identification of pulmonary nodules in children with solid primary malignancies raises the important question of when is a pulmonary nodule significant. The imaging features of pulmonary nodules in paediatrics have not been assessed to the same extent as in the adult population. There is evidence to suggest that, unlike in adults, sharply defined nodules are more likely to be malignant and small nodules (<0.5\u2009cm) are as likely to be malignant as larger nodules[14]. Attempts are now being made in a number of studies to record and identify patients with small lung nodules not deemed to be metastases to assess their long-term outcome, and risk of relapse[15]. For single nodules in particular, as no nodule feature reliably differentiates benign from malignant lesions, biopsy of indeterminate lung lesions is necessary at times to detect or rule out malignant disease (<xref ref-type="fig" rid="ci11002113">Figs. 13</xref> and and <xref ref-type="fig" rid="ci11002114">14</xref>))[16].\nFigure 14Small solitary lung nodule. Axial CT at lung window settings in a 5-year-old asymptomatic boy undergoing routine follow-up demonstrates a parenchymal nodule less than 1\u2009cm in the right lower lobe (arrow).'], 'ci11002115': ['One of the major advantages of MRI is the lack of radiation exposure. MRI also produces superior soft tissue resolution compared with many other forms of imaging and improvements in technology have produced special techniques such as magnetic resonance angiography (MRA) and diffusion-weighted imaging (DWI) (<xref ref-type="fig" rid="ci11002115">Fig. 15</xref>). MRA allows delineation of vascular anatomy without the need for conventional angiography which in oncologic imaging can be used to plan liver resections and limb salvage procedures and help differentiate vascular malformations from malignant solid tumours. DWI utilizes the molecular motion of water, and although a motion-sensitive technique, DWI can now be used in the assessment of extracranial tumours in the neck, chest, abdomen and limbs). MRA allows delineation of vascular anatomy without the need for conventional angiography which in oncologic imaging can be used to plan liver resections and limb salvage procedures and help differentiate vascular malformations from malignant solid tumours. DWI utilizes the molecular motion of water, and although a motion-sensitive technique, DWI can now be used in the assessment of extracranial tumours in the neck, chest, abdomen and limbs[17]. MRI is superior to any other modality in assessment of the spinal cord for cord compression and MRI is the preferred modality for imaging musculoskeletal tumours and assessing bone marrow disease. MRI is generally regarded as the ideal modality for evaluating primary liver tumours and genito-urinary tract malignancies.\nFigure 15Neuroblastoma. (a) Axial T2-weighted MRI shows residual tumour at the left paraspinal and intraspinal foramen area (3 smaller arrows). The spleen (larger single arrow) has an unusual position consequent to previous displacement by tumour and later surgical removal of the large infiltrating upper abdominal tumour. (b) Restricted diffusion is seen in the paraspinal tumour mass (black arrow), suggesting high cellularity and residual viable tumour. The spleen also has restricted diffusion which is a normal finding (white arrow).'], 'ci11002116': ['It is important to recognize that both abscesses and tumours can demonstrate similar restricted diffusion on DWI[18]. Abscesses, however, do not show contrast enhancement after gadolinium administration on T1-weighted sequences. Marrow metastases are easily demonstrated with MRI, but the changes tend to persist on follow-up such that marrow changes cannot be relied on to monitor response to treatment or disease progression. Whole-body MRI is sensitive in the detection of lymph nodes but has poor specificity in children for predicting which nodes are infiltrated by cancer cells. It may be useful in searching for metastases when a neuroblastoma primary tumour is not metaiodobenzylguanidine (MIBG) avid. Calcification is underestimated or missed at MRI. Calcification is typical of myositis ossificans, a benign process, but is easily missed when evaluating the lesion solely with MRI, leading to unnecessary biopsy and potentially serious treatment errors. Pulsation artefact in vessels may mimic tumour thrombus (<xref ref-type="fig" rid="ci11002116">Fig. 16</xref>). With renal tumours, for example, evaluation for IVC thrombus is most reliably performed with US. Contrast medium may not be needed at MRI to evaluate all solid tumours but all renal tumours in childhood merit gadolinium-enhanced sequences to assess for contralateral tumour. In addition, in cases of Wilms tumour, gadolinium-enhanced images are necessary to detect foci of nephroblastomatosis. Children with residual area of nephroblastomatosis after treatment of the primary Wilms tumour are more likely to re-present later with metachronous tumours. Most soft tissue tumours do not have characteristic features on MRI). With renal tumours, for example, evaluation for IVC thrombus is most reliably performed with US. Contrast medium may not be needed at MRI to evaluate all solid tumours but all renal tumours in childhood merit gadolinium-enhanced sequences to assess for contralateral tumour. In addition, in cases of Wilms tumour, gadolinium-enhanced images are necessary to detect foci of nephroblastomatosis. Children with residual area of nephroblastomatosis after treatment of the primary Wilms tumour are more likely to re-present later with metachronous tumours. Most soft tissue tumours do not have characteristic features on MRI[19]. Soft tissue sarcomas can look similar to venous malformations (<xref ref-type="fig" rid="ci11002117">Fig. 17</xref>) and synovial sarcoma is often initially misinterpreted as a benign cystic mass or even a haematoma. A biopsy is therefore an essential aspect of diagnosis whenever there is diagnostic uncertainty, as imaging cannot differentiate benign from malignant processes, and imaging cannot reliably predict the histological diagnosis.\n) and synovial sarcoma is often initially misinterpreted as a benign cystic mass or even a haematoma. A biopsy is therefore an essential aspect of diagnosis whenever there is diagnostic uncertainty, as imaging cannot differentiate benign from malignant processes, and imaging cannot reliably predict the histological diagnosis.\nFigure 16Wilms tumour. (a) Axial T2-weighted MRI shows a large right renal mass and signal void due to flowing blood in a patent IVC (arrow). US had also confirmed IVC patency, and no tumour thrombus. (b) A pseudothrombus appearance is created from pulsation artefact in the IVC on a fat-suppressed T1-weighted MRI after gadolinium enhancement (arrow).\nFigure 17Venous malformation (VM). (a) A 2-year-old girl with a heterogeneous gluteal mass lesion on T2-weighted images, which (b) shows a fluid-fluid level (arrow) on a fat-saturated T1-weighted image. The MRI appearances were very suggestive of a VM but on clinical evaluation the mass was a firm hard lump, which is unusual for any vascular malformation. Biopsy confirmed VM with a predominant fibrous component which accounted for the clinical findings.'], 'ci11002118': ['The main value of [123I]MIBG scan in the management of children with neuroblastoma is in providing a whole-body depiction of the extent of disease, both at staging, in the evaluation of response to chemotherapy and at the end of treatment (<xref ref-type="fig" rid="ci11002118">Fig. 18</xref>). Approximately 5% of neuroblastomas are MIBG negative and either FDG-PET or (where available) [). Approximately 5% of neuroblastomas are MIBG negative and either FDG-PET or (where available) [68Ga]DOTATE-PET are valuable alternative tracers.\nFigure 18A 5-year-old boy with a history of a sarcoma of the right buttock. At the end of treatment, cross-sectional imaging showed a new mass in the right adrenal. Histology suggested a neuroblastic tumour. Planar images of an [123I]MIBG scan show massive metastatic infiltration within the skeleton. There are two focal areas of increased tracer uptake within the liver, in keeping with two liver metastases (arrows). The primary tumour in the right suprarenal region is not clearly visible. The findings are compatible with stage 4 neuroblastoma, with massive skeletal infiltration and at least two liver metastases. The child died after induction chemotherapy.']} | Pitfalls in paediatric oncology imaging | [
"Paediatric",
"radiology",
"oncology",
"ultrasonography",
"CT",
"MRI",
"PET/CT",
"SPECT"
] | Cancer Imaging | 1316847600 | Imaging a new mass lesion in a child requires careful consideration of a variety of issues. The age of the child is an important factor in determining the appropriate test to start with and the age also helps provide an appropriate differential diagnosis, which can then be used to guide further imaging. The long-term outcome for most children with cancer is very good, with over 70% achieving 5-year survival and presumed cure. Consequently their imaging requirements should be regarded as equal to all other children. Minimizing exposure to ionizing radiation, particularly where follow-up imaging is required is an important consideration. This article focuses specifically on general paediatric radiology and neuro-oncology imaging is not addressed. The pitfalls to be aware of in plain radiography, ultrasonography, computed tomography, magnetic resonance imaging and nuclear medicine (positron emission tomography-computed tomography and single photon emission computed tomography) in children with a proven or suspected malignancy are discussed. | [
"Child",
"Diagnostic Imaging",
"Humans",
"Magnetic Resonance Imaging",
"Neoplasms",
"Positron-Emission Tomography",
"Tomography, Emission-Computed, Single-Photon",
"Tomography, X-Ray Computed"
] | other | PMC3205763 | null | 22 | [
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(A) Chest computed tomography scan of a 16-year-old patient with Lemierre syndrome with marked pulmonary involvement shows a large, left-sided pneumothorax (arrow) and adjacent empyema. (B) Chest computed tomography scan of the same patient shows widespread bilateral pulmonary consolidation and nodular foci. The central cavitation in the lesion is marked by an arrow. (C) Coronal magnetic resonance image shows the hip region in the same patient, who also developed septic arthritis of the left hip joint and abscess formation in the adjacent muscles. Notice the synovial enhancement (small arrow) and the fluid collection (large arrow), which extended anteriorly between the iliopsoas, the rectus femoris medially, and the gluteus muscles laterally. | f028-002c-9780323401814 | 7 | 9f31bab38a3e5d35ac70677ab967926f49ca35e609adb26659cf968f253a84bf | f028-002c-9780323401814.jpg | multiple | multiple panels: images | [
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Bony structures are the mandible (top), hyoid bone, and the cervical vertebrae.', 'hash': 'dfc8e9c2356a8e54bc819d768d53615831138d87475ff862d0b16d492b1e6e37'}, {'image_id': 'f028-001c-9780323401814', 'image_file_name': 'f028-001c-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-001c-9780323401814.jpg', 'caption': '(A) Lateral neck radiograph of an 18-month-old toddler shows a retropharyngeal abscess due to Staphylococcus aureus infection. Notice the marked retropharyngeal soft tissue density (arrow) with anterior displacement of the hypopharynx and the laryngotracheal airway and the normal appearance of the epiglottis, glottis, and subglottic airway. (B) The chest radiograph shows an extension of the infection into the mediastinum (arrow). (C) Computed tomography scan without contrast of the upper cervical region shows an abscess in the retropharyngeal space (arrow) with anterior displacement and compression of the airway and lateral displacement of the great vessels. Bony structures are the mandible (top), hyoid bone, and the cervical vertebrae.', 'hash': '7df8d89db1cb5289402f7e6a39791baf06bcf07fd8555e4ea703c2dec586b0c3'}, {'image_id': 'f028-002a-9780323401814', 'image_file_name': 'f028-002a-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-002a-9780323401814.jpg', 'caption': '(A) Chest computed tomography scan of a 16-year-old patient with Lemierre syndrome with marked pulmonary involvement shows a large, left-sided pneumothorax (arrow) and adjacent empyema. (B) Chest computed tomography scan of the same patient shows widespread bilateral pulmonary consolidation and nodular foci. The central cavitation in the lesion is marked by an arrow. (C) Coronal magnetic resonance image shows the hip region in the same patient, who also developed septic arthritis of the left hip joint and abscess formation in the adjacent muscles. Notice the synovial enhancement (small arrow) and the fluid collection (large arrow), which extended anteriorly between the iliopsoas, the rectus femoris medially, and the gluteus muscles laterally.', 'hash': '0944c1b3392c8ae8bb6c969a42fe9fedfa1b73fdb389ba4e25e7c71e74caf385'}, {'image_id': 'f028-004b-9780323401814', 'image_file_name': 'f028-004b-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-004b-9780323401814.jpg', 'caption': '(A) Lateral neck radiograph of a 22-month-old boy with bacterial tracheitis caused by Staphylococcus aureus shows subglottic haziness (similar to croup). (B) Endoscopic view of the trachea shows mucosal denudation, intraluminal debris, and purulent laryngotracheal secretions.', 'hash': '7bb138c5f2fc2ff3dd3c9116be5d5131b0c165ae386eeceac7e5e18098fa4bb1'}, {'image_id': 'f028-004a-9780323401814', 'image_file_name': 'f028-004a-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-004a-9780323401814.jpg', 'caption': '(A) Lateral neck radiograph of a 22-month-old boy with bacterial tracheitis caused by Staphylococcus aureus shows subglottic haziness (similar to croup). (B) Endoscopic view of the trachea shows mucosal denudation, intraluminal debris, and purulent laryngotracheal secretions.', 'hash': '5d9c42e9ee5368699675316100cc8da655c5d8153d4ae35716c6d184be6d7f47'}, {'image_id': 'f028-002b-9780323401814', 'image_file_name': 'f028-002b-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-002b-9780323401814.jpg', 'caption': '(A) Chest computed tomography scan of a 16-year-old patient with Lemierre syndrome with marked pulmonary involvement shows a large, left-sided pneumothorax (arrow) and adjacent empyema. (B) Chest computed tomography scan of the same patient shows widespread bilateral pulmonary consolidation and nodular foci. The central cavitation in the lesion is marked by an arrow. (C) Coronal magnetic resonance image shows the hip region in the same patient, who also developed septic arthritis of the left hip joint and abscess formation in the adjacent muscles. Notice the synovial enhancement (small arrow) and the fluid collection (large arrow), which extended anteriorly between the iliopsoas, the rectus femoris medially, and the gluteus muscles laterally.', 'hash': '346b96b1b76b1323b8f0e2a2ea57f5455d2f3b4c00299c1a253b4ac52058d79b'}, {'image_id': 'f028-003-9780323401814', 'image_file_name': 'f028-003-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-003-9780323401814.jpg', 'caption': 'Lateral neck radiograph of a 4-year-old child with acute epiglottitis shows the characteristically distended hypopharynx and “thumbprint” edematous epiglottis and aryepiglottic folds (arrow).', 'hash': 'caa3558169892339926ebb16d98c9e4fceaf734561b432cd32ba0fc1d25aaaa9'}, {'image_id': 'f028-001a-9780323401814', 'image_file_name': 'f028-001a-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-001a-9780323401814.jpg', 'caption': '(A) Lateral neck radiograph of an 18-month-old toddler shows a retropharyngeal abscess due to Staphylococcus aureus infection. Notice the marked retropharyngeal soft tissue density (arrow) with anterior displacement of the hypopharynx and the laryngotracheal airway and the normal appearance of the epiglottis, glottis, and subglottic airway. (B) The chest radiograph shows an extension of the infection into the mediastinum (arrow). (C) Computed tomography scan without contrast of the upper cervical region shows an abscess in the retropharyngeal space (arrow) with anterior displacement and compression of the airway and lateral displacement of the great vessels. Bony structures are the mandible (top), hyoid bone, and the cervical vertebrae.', 'hash': 'd4e34752d73edbc41cfbe92e82828b094afaec7f1c52425a2fb2ed5c2d0dc25d'}, {'image_id': 'f028-002c-9780323401814', 'image_file_name': 'f028-002c-9780323401814.jpg', 'image_path': '../data/media_files/PMC7152082/f028-002c-9780323401814.jpg', 'caption': '(A) Chest computed tomography scan of a 16-year-old patient with Lemierre syndrome with marked pulmonary involvement shows a large, left-sided pneumothorax (arrow) and adjacent empyema. (B) Chest computed tomography scan of the same patient shows widespread bilateral pulmonary consolidation and nodular foci. The central cavitation in the lesion is marked by an arrow. (C) Coronal magnetic resonance image shows the hip region in the same patient, who also developed septic arthritis of the left hip joint and abscess formation in the adjacent muscles. Notice the synovial enhancement (small arrow) and the fluid collection (large arrow), which extended anteriorly between the iliopsoas, the rectus femoris medially, and the gluteus muscles laterally.', 'hash': '9f31bab38a3e5d35ac70677ab967926f49ca35e609adb26659cf968f253a84bf'}] | {'f028-001a-9780323401814': ['Peripheral blood leukocytosis is common.e\nThe CRP level and erythrocyte sedimentation rate (ESR) usually are elevated.49, 52 In most cases, enlargement of the retropharyngeal space/prevertebral tissue can be seen on plain lateral neck radiographs (<xref rid="f028-001a-9780323401814" ref-type="fig">Fig. 28.1</xref>\n).\n).38, 43, 44, 56 However, CT is more sensitive and is the imaging modality of choice.43, 45, 50, 56, 57, 58, 59, 60, 61, 62\nFIGURE 28.1(A) Lateral neck radiograph of an 18-month-old toddler shows a retropharyngeal abscess due to Staphylococcus aureus infection. Notice the marked retropharyngeal soft tissue density (arrow) with anterior displacement of the hypopharynx and the laryngotracheal airway and the normal appearance of the epiglottis, glottis, and subglottic airway. (B) The chest radiograph shows an extension of the infection into the mediastinum (arrow). (C) Computed tomography scan without contrast of the upper cervical region shows an abscess in the retropharyngeal space (arrow) with anterior displacement and compression of the airway and lateral displacement of the great vessels. Bony structures are the mandible (top), hyoid bone, and the cervical vertebrae.FIGURE 28.1(Courtesy of Richard H. Schwartz, MD, Vienna, VA.)', 'The authors wish to acknowledge the use of figures and legends (<xref rid="f028-001a-9780323401814" ref-type="fig">FIGURE 28.1</xref>, , <xref rid="f028-003-9780323401814" ref-type="fig">FIGURE 28.3</xref>, , <xref rid="f028-004a-9780323401814" ref-type="fig">FIGURE 28.4</xref>), contributed by Richard H. Schwartz from the third edition.), contributed by Richard H. Schwartz from the third edition.'], 'f028-002a-9780323401814': ['Contrast-enhanced CT of the neck is the most useful investigation. Possible CT findings include distended neck veins, intraluminal filling defects, and soft tissue swelling.95, 100, 111, 113, 114 Doppler ultrasonography and magnetic resonance imaging are also useful in this setting. The chest radiograph and chest CT may reveal pulmonary infiltrates, pulmonary cavitation, or pleural effusions (<xref rid="f028-002a-9780323401814" ref-type="fig">Fig. 28.2</xref>\n).\n).FIGURE 28.2(A) Chest computed tomography scan of a 16-year-old patient with Lemierre syndrome with marked pulmonary involvement shows a large, left-sided pneumothorax (arrow) and adjacent empyema. (B) Chest computed tomography scan of the same patient shows widespread bilateral pulmonary consolidation and nodular foci. The central cavitation in the lesion is marked by an arrow. (C) Coronal magnetic resonance image shows the hip region in the same patient, who also developed septic arthritis of the left hip joint and abscess formation in the adjacent muscles. Notice the synovial enhancement (small arrow) and the fluid collection (large arrow), which extended anteriorly between the iliopsoas, the rectus femoris medially, and the gluteus muscles laterally.FIGURE 28.2', 'Metastatic infections can cause complications depending on their location. Pleural effusions, empyema, lung abscesses, and pulmonary cavitation can occur in patients with Lemierre syndrome. Pneumatocele and pneumothorax can occur. Septic pyogenic arthritis typically affects larger joints, such as the shoulder, elbow, and hip joints (see <xref rid="f028-002a-9780323401814" ref-type="fig">Fig. 28.2</xref>).).87, 101 Renal involvement can be associated with proteinuria or hematuria.'], 'f028-003-9780323401814': ['Peripheral blood leukocytosis is present in most cases.129, 137, 140, 146 Lateral neck radiographs demonstrate epiglottic enlargement with a distended hypopharynx, a classic thumb sign that has high sensitivity (<xref rid="f028-003-9780323401814" ref-type="fig">Fig. 28.3</xref>\n). However, this should be attempted only for a stable, cooperative patient in a safe environment because performing radiography in the lateral position can precipitate respiratory arrest from complete airway obstruction, especially if the child\'s neck is repositioned for optimal results.\n). However, this should be attempted only for a stable, cooperative patient in a safe environment because performing radiography in the lateral position can precipitate respiratory arrest from complete airway obstruction, especially if the child\'s neck is repositioned for optimal results.133, 137\nFIGURE 28.3Lateral neck radiograph of a 4-year-old child with acute epiglottitis shows the characteristically distended hypopharynx and “thumbprint” edematous epiglottis and aryepiglottic folds (arrow).FIGURE 28.3(Courtesy of Richard H. Schwartz, MD, Vienna, VA.)'], 'f028-004a-9780323401814': ['An inflammatory response, including an elevated CRP level and WBC count, is seen in most patients at presentation.220, 234 The radiograph may demonstrate narrowing of the tracheal air shadow and intraluminal tracheal membranes, although these are not universal findings (<xref rid="f028-004a-9780323401814" ref-type="fig">Fig. 28.4</xref>\n).\n).223, 230 Coexisting pulmonary changes, including infiltrates and atelectases, are common.220, 234, 235, 236, 237 Direct visualization of the airways reveals an unremarkable or only mildly inflamed epiglottis but shows marked subglottic inflammation, edema of the tracheal mucosa, and copious purulent endotracheal secretions.216, 234 Endotracheal aspirates should be obtained and sent for bacterial culture and susceptibility testing. Blood cultures are rarely helpful, as bacteremia is relatively uncommon in these patients.FIGURE 28.4(A) Lateral neck radiograph of a 22-month-old boy with bacterial tracheitis caused by Staphylococcus aureus shows subglottic haziness (similar to croup). (B) Endoscopic view of the trachea shows mucosal denudation, intraluminal debris, and purulent laryngotracheal secretions.FIGURE 28.4(Courtesy of Richard H. Schwartz, MD, Vienna, VA.)']} | Infections of the Upper and Middle Airways | null | Principles and Practice of Pediatric Infectious Diseases | 1531897200 | None | null | other | PMC7152082 | null | null | [
""
] | Principles and Practice of Pediatric Infectious Diseases. 2018 Jul 18;:208-215.e4 | NO-CC CODE |
|
Coronal computed tomography (CT) demonstrating acute maxillary rhinosinusitis | 144168_1_En_3_Fig4_HTML | 7 | 95e1bc6e4a1c855451f8ab90deb67c197a97bc12640223453a6699ce2e36acc5 | 144168_1_En_3_Fig4_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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"computerized tomography"
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260,
259
] | [{'image_id': '144168_1_En_3_Fig1_HTML', 'image_file_name': '144168_1_En_3_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig1_HTML.jpg', 'caption': 'Microbiology of acute bacterial rhinosinusitis in adults', 'hash': 'b6508d07b8a00e7dec4f4e89e6f4e769f89fbbc62f2a29901fa2fe12c92c5a67'}, {'image_id': '144168_1_En_3_Fig6_HTML', 'image_file_name': '144168_1_En_3_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig6_HTML.jpg', 'caption': 'Coronal CT demonstrating acute on chronic rhinosinusitis with complete opacification of bilateral ethmoid sinuses, left maxillary sinus mucosal thickening, and air bubbles within the right maxillary sinus indicating purulence', 'hash': '4d3dffdbfa458958e57a324fcee289754f68aba1b5dd4c741c06d2d63a26b551'}, {'image_id': '144168_1_En_3_Fig7_HTML', 'image_file_name': '144168_1_En_3_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig7_HTML.jpg', 'caption': 'Coronal CT demonstrating changes associated with chronic rhinosinusitis, including mucosal thickening of bilateral maxillary sinuses', 'hash': '7547b9c7c2b8b8247f977ac393b71bc100c0c31c7a182dd3ce1304dbfbbb937f'}, {'image_id': '144168_1_En_3_Fig4_HTML', 'image_file_name': '144168_1_En_3_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig4_HTML.jpg', 'caption': 'Coronal computed tomography (CT) demonstrating acute maxillary rhinosinusitis', 'hash': '95e1bc6e4a1c855451f8ab90deb67c197a97bc12640223453a6699ce2e36acc5'}, {'image_id': '144168_1_En_3_Fig3_HTML', 'image_file_name': '144168_1_En_3_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig3_HTML.jpg', 'caption': 'Waters’ view demonstrating chronic mucosal thickening', 'hash': '92e24fd6bec19951d43e50fe9e3ee0124969fe22f16810702b9fc61188ac22ed'}, {'image_id': '144168_1_En_3_Fig5_HTML', 'image_file_name': '144168_1_En_3_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig5_HTML.jpg', 'caption': 'Coronal CT demonstrating acute maxillary and ethmoid rhinosinusitis with air bubbles within fluid density, indicating purulence in the right maxillary sinus', 'hash': '8d792b7942d85bb09da74bad9b0f7b041ee0ebf6b00e0da11f906a7e3a84d2d8'}, {'image_id': '144168_1_En_3_Fig2_HTML', 'image_file_name': '144168_1_En_3_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig2_HTML.jpg', 'caption': 'Caldwell view of the sinuses demonstrating well-pneumatized paranasal sinuses (A) versus chronic mucosal thickening (B)', 'hash': 'e0aaba1896ff9cb06f3a2ab707de9e2ba8e8371b8a522f389ae1c5753a7a2ae2'}] | {'144168_1_En_3_Fig1_HTML': ['Bacteria subsequently superinfect the sinonasal mucosa, as shown by repeated sinus aspiration studies demonstrating that 60% of adults with URI symptoms for 10 days or more have significant bacterial growth in sinus cultures. Isolates from maxillary sinus aspirates show that the most common pathogens are Streptococcus pneumoniae and Haemophilus influenzae, together comprising more than half of the bacterial isolates. Figure <xref rid="144168_1_En_3_Fig1_HTML" ref-type="fig">3.1</xref> displays the incidence of bacterial pathogens in acute maxillary rhinosinusitis in an adult population [ displays the incidence of bacterial pathogens in acute maxillary rhinosinusitis in an adult population [6].Fig. 3.1Microbiology of acute bacterial rhinosinusitis in adults\n'], '144168_1_En_3_Fig2_HTML': ['Plain X-ray has been used to evaluate the presence of air-fluid levels or mucosal thickening in the paranasal sinuses. Waters’ (occipitomental) view, where the X-ray beam is oriented through the chin, is used to obtain views of the maxillary and frontal sinuses. In the Caldwell view, the X-ray beam is oriented directly through the forehead and is used to evaluate the frontal sinus. In one report, the sensitivity and specificity are somewhat modest at 76% and 79%, respectively [23]. When evaluating the efficacy of using a single Waters’ view for diagnosing acute maxillary versus frontal rhinosinusitis, the accuracy has been shown to be even worse. When evaluating the maxillary sinus, a single Waters’ view has a false-negative rate of 32% and a mean negative predictive value of 76.9%; and the sensitivity for evaluating the frontal sinus is only 14.6% when compared to CT. Radiologists in this study also could not commit to a diagnosis when evaluating the ethmoid and sphenoid sinuses, indicating that this modality is not adequate for the evaluation of these sinuses [24,25]. Figures <xref rid="144168_1_En_3_Fig2_HTML" ref-type="fig">3.2</xref> and and <xref rid="144168_1_En_3_Fig3_HTML" ref-type="fig">3.3</xref> are plain X-rays of Caldwell and Waters views demonstrating mucosal thickening. These images reveal how the diagnosis of acute rhinosinusitis from X-ray can be difficult. Structural overlapping can lead to the impression of edematous mucosa, a hypoplastic sinus can be misinterpreted as pathological opacification, and infection can be difficult to distinguish from tumor and polyp.\n are plain X-rays of Caldwell and Waters views demonstrating mucosal thickening. These images reveal how the diagnosis of acute rhinosinusitis from X-ray can be difficult. Structural overlapping can lead to the impression of edematous mucosa, a hypoplastic sinus can be misinterpreted as pathological opacification, and infection can be difficult to distinguish from tumor and polyp.\nFig. 3.2Caldwell view of the sinuses demonstrating well-pneumatized paranasal sinuses (A) versus chronic mucosal thickening (B)\nFig. 3.3Waters’ view demonstrating chronic mucosal thickening\n'], '144168_1_En_3_Fig4_HTML': ['Computed tomography (CT) in acute rhinosinusitis demonstrates partial or complete opacification, air-fluid levels, and air bubbles within fluid levels in the paranasal sinuses (Fig. <xref rid="144168_1_En_3_Fig4_HTML" ref-type="fig">3.4</xref>). This finding contrasts to chronic rhinosinusitis that may show mucosal thickening in addition to complete opacification (Figs. ). This finding contrasts to chronic rhinosinusitis that may show mucosal thickening in addition to complete opacification (Figs. <xref rid="144168_1_En_3_Fig5_HTML" ref-type="fig">3.5</xref>, , <xref rid="144168_1_En_3_Fig6_HTML" ref-type="fig">3.6</xref>, , <xref rid="144168_1_En_3_Fig7_HTML" ref-type="fig">3.7</xref>). CT, although more sensitive than plain films, is not specific, as demonstrated by partial opacification noted on up to 42% of head CTs performed for various reasons, and unrelated to the paranasal sinuses [). CT, although more sensitive than plain films, is not specific, as demonstrated by partial opacification noted on up to 42% of head CTs performed for various reasons, and unrelated to the paranasal sinuses [26]. In addition, CT cannot distinguish between viral and bacterial rhinosinusitis, as opacification of the infundibulum and paranasal sinuses can be seen on CT scan 48\xa0h after the onset of cold-type symptoms [27]. CT radiography has also shown to have no effect on outcome [28].Fig. 3.4Coronal computed tomography (CT) demonstrating acute maxillary rhinosinusitis\nFig. 3.5Coronal CT demonstrating acute maxillary and ethmoid rhinosinusitis with air bubbles within fluid density, indicating purulence in the right maxillary sinus\nFig. 3.6Coronal CT demonstrating acute on chronic rhinosinusitis with complete opacification of bilateral ethmoid sinuses, left maxillary sinus mucosal thickening, and air bubbles within the right maxillary sinus indicating purulence\nFig. 3.7Coronal CT demonstrating changes associated with chronic rhinosinusitis, including mucosal thickening of bilateral maxillary sinuses\n']} | Diagnosis and Management of Acute Rhinosinusitis | [
"Paranasal Sinus",
"Frontal Sinus",
"Chronic Rhinosinusitis",
"Primary Ciliary Dyskinesia",
"Subdural Empyema"
] | Rhinosinusitis | 1219215600 | None | null | other | PMC7121979 | null | null | [
""
] | Rhinosinusitis. 2008 Aug 20;:1-11 | NO-CC CODE |
|
Coronal CT demonstrating acute maxillary and ethmoid rhinosinusitis with air bubbles within fluid density, indicating purulence in the right maxillary sinus | 144168_1_En_3_Fig5_HTML | 7 | 8d792b7942d85bb09da74bad9b0f7b041ee0ebf6b00e0da11f906a7e3a84d2d8 | 144168_1_En_3_Fig5_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
260,
228
] | [{'image_id': '144168_1_En_3_Fig1_HTML', 'image_file_name': '144168_1_En_3_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig1_HTML.jpg', 'caption': 'Microbiology of acute bacterial rhinosinusitis in adults', 'hash': 'b6508d07b8a00e7dec4f4e89e6f4e769f89fbbc62f2a29901fa2fe12c92c5a67'}, {'image_id': '144168_1_En_3_Fig6_HTML', 'image_file_name': '144168_1_En_3_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig6_HTML.jpg', 'caption': 'Coronal CT demonstrating acute on chronic rhinosinusitis with complete opacification of bilateral ethmoid sinuses, left maxillary sinus mucosal thickening, and air bubbles within the right maxillary sinus indicating purulence', 'hash': '4d3dffdbfa458958e57a324fcee289754f68aba1b5dd4c741c06d2d63a26b551'}, {'image_id': '144168_1_En_3_Fig7_HTML', 'image_file_name': '144168_1_En_3_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig7_HTML.jpg', 'caption': 'Coronal CT demonstrating changes associated with chronic rhinosinusitis, including mucosal thickening of bilateral maxillary sinuses', 'hash': '7547b9c7c2b8b8247f977ac393b71bc100c0c31c7a182dd3ce1304dbfbbb937f'}, {'image_id': '144168_1_En_3_Fig4_HTML', 'image_file_name': '144168_1_En_3_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig4_HTML.jpg', 'caption': 'Coronal computed tomography (CT) demonstrating acute maxillary rhinosinusitis', 'hash': '95e1bc6e4a1c855451f8ab90deb67c197a97bc12640223453a6699ce2e36acc5'}, {'image_id': '144168_1_En_3_Fig3_HTML', 'image_file_name': '144168_1_En_3_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig3_HTML.jpg', 'caption': 'Waters’ view demonstrating chronic mucosal thickening', 'hash': '92e24fd6bec19951d43e50fe9e3ee0124969fe22f16810702b9fc61188ac22ed'}, {'image_id': '144168_1_En_3_Fig5_HTML', 'image_file_name': '144168_1_En_3_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig5_HTML.jpg', 'caption': 'Coronal CT demonstrating acute maxillary and ethmoid rhinosinusitis with air bubbles within fluid density, indicating purulence in the right maxillary sinus', 'hash': '8d792b7942d85bb09da74bad9b0f7b041ee0ebf6b00e0da11f906a7e3a84d2d8'}, {'image_id': '144168_1_En_3_Fig2_HTML', 'image_file_name': '144168_1_En_3_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC7121979/144168_1_En_3_Fig2_HTML.jpg', 'caption': 'Caldwell view of the sinuses demonstrating well-pneumatized paranasal sinuses (A) versus chronic mucosal thickening (B)', 'hash': 'e0aaba1896ff9cb06f3a2ab707de9e2ba8e8371b8a522f389ae1c5753a7a2ae2'}] | {'144168_1_En_3_Fig1_HTML': ['Bacteria subsequently superinfect the sinonasal mucosa, as shown by repeated sinus aspiration studies demonstrating that 60% of adults with URI symptoms for 10 days or more have significant bacterial growth in sinus cultures. Isolates from maxillary sinus aspirates show that the most common pathogens are Streptococcus pneumoniae and Haemophilus influenzae, together comprising more than half of the bacterial isolates. Figure <xref rid="144168_1_En_3_Fig1_HTML" ref-type="fig">3.1</xref> displays the incidence of bacterial pathogens in acute maxillary rhinosinusitis in an adult population [ displays the incidence of bacterial pathogens in acute maxillary rhinosinusitis in an adult population [6].Fig. 3.1Microbiology of acute bacterial rhinosinusitis in adults\n'], '144168_1_En_3_Fig2_HTML': ['Plain X-ray has been used to evaluate the presence of air-fluid levels or mucosal thickening in the paranasal sinuses. Waters’ (occipitomental) view, where the X-ray beam is oriented through the chin, is used to obtain views of the maxillary and frontal sinuses. In the Caldwell view, the X-ray beam is oriented directly through the forehead and is used to evaluate the frontal sinus. In one report, the sensitivity and specificity are somewhat modest at 76% and 79%, respectively [23]. When evaluating the efficacy of using a single Waters’ view for diagnosing acute maxillary versus frontal rhinosinusitis, the accuracy has been shown to be even worse. When evaluating the maxillary sinus, a single Waters’ view has a false-negative rate of 32% and a mean negative predictive value of 76.9%; and the sensitivity for evaluating the frontal sinus is only 14.6% when compared to CT. Radiologists in this study also could not commit to a diagnosis when evaluating the ethmoid and sphenoid sinuses, indicating that this modality is not adequate for the evaluation of these sinuses [24,25]. Figures <xref rid="144168_1_En_3_Fig2_HTML" ref-type="fig">3.2</xref> and and <xref rid="144168_1_En_3_Fig3_HTML" ref-type="fig">3.3</xref> are plain X-rays of Caldwell and Waters views demonstrating mucosal thickening. These images reveal how the diagnosis of acute rhinosinusitis from X-ray can be difficult. Structural overlapping can lead to the impression of edematous mucosa, a hypoplastic sinus can be misinterpreted as pathological opacification, and infection can be difficult to distinguish from tumor and polyp.\n are plain X-rays of Caldwell and Waters views demonstrating mucosal thickening. These images reveal how the diagnosis of acute rhinosinusitis from X-ray can be difficult. Structural overlapping can lead to the impression of edematous mucosa, a hypoplastic sinus can be misinterpreted as pathological opacification, and infection can be difficult to distinguish from tumor and polyp.\nFig. 3.2Caldwell view of the sinuses demonstrating well-pneumatized paranasal sinuses (A) versus chronic mucosal thickening (B)\nFig. 3.3Waters’ view demonstrating chronic mucosal thickening\n'], '144168_1_En_3_Fig4_HTML': ['Computed tomography (CT) in acute rhinosinusitis demonstrates partial or complete opacification, air-fluid levels, and air bubbles within fluid levels in the paranasal sinuses (Fig. <xref rid="144168_1_En_3_Fig4_HTML" ref-type="fig">3.4</xref>). This finding contrasts to chronic rhinosinusitis that may show mucosal thickening in addition to complete opacification (Figs. ). This finding contrasts to chronic rhinosinusitis that may show mucosal thickening in addition to complete opacification (Figs. <xref rid="144168_1_En_3_Fig5_HTML" ref-type="fig">3.5</xref>, , <xref rid="144168_1_En_3_Fig6_HTML" ref-type="fig">3.6</xref>, , <xref rid="144168_1_En_3_Fig7_HTML" ref-type="fig">3.7</xref>). CT, although more sensitive than plain films, is not specific, as demonstrated by partial opacification noted on up to 42% of head CTs performed for various reasons, and unrelated to the paranasal sinuses [). CT, although more sensitive than plain films, is not specific, as demonstrated by partial opacification noted on up to 42% of head CTs performed for various reasons, and unrelated to the paranasal sinuses [26]. In addition, CT cannot distinguish between viral and bacterial rhinosinusitis, as opacification of the infundibulum and paranasal sinuses can be seen on CT scan 48\xa0h after the onset of cold-type symptoms [27]. CT radiography has also shown to have no effect on outcome [28].Fig. 3.4Coronal computed tomography (CT) demonstrating acute maxillary rhinosinusitis\nFig. 3.5Coronal CT demonstrating acute maxillary and ethmoid rhinosinusitis with air bubbles within fluid density, indicating purulence in the right maxillary sinus\nFig. 3.6Coronal CT demonstrating acute on chronic rhinosinusitis with complete opacification of bilateral ethmoid sinuses, left maxillary sinus mucosal thickening, and air bubbles within the right maxillary sinus indicating purulence\nFig. 3.7Coronal CT demonstrating changes associated with chronic rhinosinusitis, including mucosal thickening of bilateral maxillary sinuses\n']} | Diagnosis and Management of Acute Rhinosinusitis | [
"Paranasal Sinus",
"Frontal Sinus",
"Chronic Rhinosinusitis",
"Primary Ciliary Dyskinesia",
"Subdural Empyema"
] | Rhinosinusitis | 1219215600 | None | null | other | PMC7121979 | null | null | [
""
] | Rhinosinusitis. 2008 Aug 20;:1-11 | NO-CC CODE |
|
8-year-old girl with MIS-C who presented with abdominal pain, diarrhea, fever, tachycardia and hypotension. Coronal contrast-enhanced CT image demonstrates a cluster of enlarged mesenteric lymph nodes in the right lower quadrant (arrows). There is diffuse mild fluid distention of small and large bowel consistent with ileus. | gr30_lrg | 7 | 185bd688c0aefde2ad00116c8aaf96df7c04eafb0686b33af7b3b36c8872315b | gr30_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
715,
1005
] | [{'image_id': 'gr17_lrg', 'image_file_name': 'gr17_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr17_lrg.jpg', 'caption': '58-year-old male with history of hypertension and diabetes presented to the Emergency Room with worsening abdominal pain who tested positive for SARS-CoV2 1\xa0week ago and lacked respiratory symptoms. (a) Axial and (b) coronal contrast-enhanced CT demonstrates multiple geographic wedge shaped non-enhancing splenic defects (arrowheads). (c) Axial contrast-enhanced CT 4\xa0months later shows small linear band like areas of hypoattenuation with overlying capsular retraction consistent with scarring (arrowheads).', 'hash': 'cda6faedb2c62c9013558d888473cdaf5df4cad5182e4c80830532e91e421bea'}, {'image_id': 'gr13_lrg', 'image_file_name': 'gr13_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr13_lrg.jpg', 'caption': '65-year-old woman with COVID-19 pneumonia presented with elevated creatinine and acute kidney injury. Her past medical history was notable for hypertension and remote history of breast cancer. (a) Axial and (b) coronal contrast-enhanced CT images show patchy mottled inhomogeneous renal enhancement of both kidneys that are of normal size.', 'hash': '633eeb8bb10e5e200cc585a061c10749f4d6446b59a92413240eff0e0e9ea780'}, {'image_id': 'gr30_lrg', 'image_file_name': 'gr30_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr30_lrg.jpg', 'caption': '8-year-old girl with MIS-C who presented with abdominal pain, diarrhea, fever, tachycardia and hypotension. Coronal contrast-enhanced CT image demonstrates a cluster of enlarged mesenteric lymph nodes in the right lower quadrant (arrows). There is diffuse mild fluid distention of small and large bowel consistent with ileus.', 'hash': '185bd688c0aefde2ad00116c8aaf96df7c04eafb0686b33af7b3b36c8872315b'}, {'image_id': 'gr8_lrg', 'image_file_name': 'gr8_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr8_lrg.jpg', 'caption': '54-year-old man with COVID-19 with history of obesity and diabetes mellitus. (a,b) Axial and coronal contrast-enhanced CT images show mild dilatation (8\xa0mm) and mural hyperenhancement of the common bile duct (arrow). Ultrasound (not shown) shows absence of gallstones. (c,d) Axial and coronal images from CT from 1-year prior show a normal common bile duct (arrow).', 'hash': 'c39ff16deba19e2201f03a8e875310988f18ec820ce555d0d80d9101774ae980'}, {'image_id': 'gr4_lrg', 'image_file_name': 'gr4_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr4_lrg.jpg', 'caption': 'Hepatic steatosis in a 44\xa0year old male with COVID-19 and elevated liver enzymes.(a) Axial in and (b) out-of-phase MRI images show loss of signal in the liver parenchyma on the out of phase sequence consistent with intracellular fat. Note focal high signal due to fatty sparing in the medial segment of the left lobe (arrow).', 'hash': '284655513426e6c1f3753fd7f6b5e031ea9758040141cbb6ca1dbaa7ad1f6919'}, {'image_id': 'gr25_lrg', 'image_file_name': 'gr25_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr25_lrg.jpg', 'caption': '74-year-old morbidly obese woman with history of breast cancer and prolonged ICU hospitalization for severe COVID-19 pneumonia causing acute respiratory failure. One week after discharge to a nursing home, she was readmitted to the hospital for fever, hypotension and diarrhea. (a) Coronal non-contrast CT image with oral contrast shows prominent right and left colonic mural thickening (arrows) which involved the entire colon (not shown). (b) Axial image better shows the extent of mural thickening in the right colon (arrow) due to luminal contrast. Clostridium difficile infection was confirmed and she improved after treatment with oral Vancomycin and IV Flagyl. Her course was subsequently further complicated by gastrointestinal bleeding and retroperitoneal hemorrhage due to anticoagulation. (c) Axial non-contrast CT image shows hyperdense content expanding both psoas muscles (arrows), and in the right paracolic gutter (arrowhead).', 'hash': '69ce4e3e54f8c7530bddd1300af6c98b300e6e30a930291828b3c63374ccb311'}, {'image_id': 'gr21_lrg', 'image_file_name': 'gr21_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr21_lrg.jpg', 'caption': "61-year-old man with no significant past medical history in the ICU for one month for respiratory failure due to COVID-19 pneumonia underwent CT scan of the chest, abdomen and pelvis because of persistent fever and leukocytosis despite broad spectrum antibiotics. (a) Supine scout shows bilateral interstitial infiltrates and marked colonic ileus. (b) Axial contrast-enhanced CT image shows portal venous gas (arrow) in the periphery of the left hepatic lobe. (c) Coronal CT images shows pneumatosis of the entire right colon (arrow) and a distal ileal loop (arrowhead) with mild mesenteric haziness. (d) Axial CT image shows extensive distal ileal pneumatosis (arrowhead) with adjacent branching mesenteric venous gas (thin arrows). Despite the findings of bowel ischemia, due to the patient's advanced septic condition, he was not a surgical candidate and died the following day. Additional imaging during his hospital course confirmed evidence of acute kidney injury with (e) longitudinal ultrasound image of his left kidney showing increased cortical echogenicity with increased conspicuity of the pyramids (arrowheads). He also had signs of liver injury with rising liver function tests and (f) longitudinal ultrasound image of the right hepatic lobe showing increased echogenicity suggestive of steatosis.", 'hash': 'd4bab4428802415919807c7fff342c0d0440b0d606f54b749f62ba99d13c0ce3'}, {'image_id': 'gr29_lrg', 'image_file_name': 'gr29_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr29_lrg.jpg', 'caption': '9-year-old girl with MIS-C who presented with abdominal pain, vomiting, fever, hypotension and acute renal failure. (a) Transverse gray-scale ultrasound image of the right upper quadrant shows mild wall thickening of the gallbladder (GB). (b) Transverse gray-scale ultrasound image of the right lower quadrant demonstrates multiple fluid-filled thick-walled loops of small bowel (*). (c) Sagittal gray-scale ultrasound image of the right lower quadrant shows multiple enlarged hypoechoic mesenteric lymph nodes (LN) lacking echogenic hila, with thickening of the surrounding fat.', 'hash': '2fac02955b2c5def5c3a94b735e138ba9f6eb53d3a2a6a9a325b0ffd6596c749'}, {'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr1_lrg.jpg', 'caption': '40-year-old man with COVID-19 pneumonia and no known liver disease with increasing liver function tests. (1a) Sagittal gray-scale ultrasound image demonstrates increased liver echogenicity, consistent with steatosis without hepatomegaly. (1b) Sagittal gray-scale ultrasound image shows a normal gallbladder (arrow) and no biliary dilatation (not shown).', 'hash': '2d09c82a9bdd80e56624828bfcbdd65b29ea1bb29e8ead59357e073b78e95355'}, {'image_id': 'gr5_lrg', 'image_file_name': 'gr5_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr5_lrg.jpg', 'caption': '49-year-old man with COVID-19 pneumonia who has a history of coronary artery disease and diabetes mellitus. (a) Axial contrast-enhanced CT image shows hypodense thrombus in the distal right portal vein (arrow) extending into the posterior segmental branch (arrowhead) with associated heterogeneous right lobe enhancement. (b) Sagittal Color Doppler US image shows absent flow and no spectral waveform consistent with occlusive thrombus. (c) More cephalic image shows heterogenous hepatic enhancement with several rounded hypoattenuated foci consistent with parenchymal inflammation and abscesses. The patient was treated with anticoagulation and antibiotics. (d,e) Axial contrast-enhanced CT images 3\xa0months later shows gross resolution of abscesses with persistent geographic hypoattenuation due to perfusion change (arrowheads) with only slight decrease in right portal vein thrombosis (arrow).', 'hash': '96be0e476e9f6ee7cdca23169216ba7c7f258fe228539082ff8e8c44acfb8e0e'}, {'image_id': 'gr9_lrg', 'image_file_name': 'gr9_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr9_lrg.jpg', 'caption': '60-year-old man with history of hypertension and asthma hospitalized for COVID-19 pneumonia with respiratory distress requiring oxygen supplementation and with diffuse abdominal pain and leukocytosis. (a) Axial CT image with lung windows shows bibasilar infiltrates. (b,c) Axial and coronal contrast-enhanced CT images show a hydropic gallbladder with stones (arrow). Hepatobiliary iminodiacetic acid (HIDA) scan was positive confirming acute cholecystitis. Percutaneous cholecystostomy was performed with clear yellow bile drained. Cholecystectomy was performed 4\xa0weeks later revealing chronic cholecystitis and stones. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)', 'hash': '736d46ac76aa90d61f5f3bf07a1df9c2c3eaf105456da253afb4c5e57d4e1e86'}, {'image_id': 'gr28_lrg', 'image_file_name': 'gr28_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr28_lrg.jpg', 'caption': '5-year-old girl with COVID-19 and MIS-C who presented with fever, conjunctivitis and vomiting. Axial chest CT image with lung (a) and soft tissue (b) windows shows mild dependent ground-glass opacities in both lungs, and bilateral small pleural effusions.', 'hash': '571f0067e92b2dbad51e93c6c4d64d2bb00c622c81533d7753d2cc6d8a213aae'}, {'image_id': 'gr24_lrg', 'image_file_name': 'gr24_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr24_lrg.jpg', 'caption': '82-year-old woman with chronic obstructive pulmonary disease and end-stage renal disease sent from the nursing home 4\xa0weeks after testing positive for COVID-19 with leukocytosis. (a) Axial contrast-enhanced CT image show a mildly thick-walled duodenal bulbar region (arrows) with a small anterior defect and extraluminal gas (arrowhead) consistent with locally perforated ulcer. Two small left renal cysts are present. (b) Coronal CT image shows a small walled off fluid collection with fluid and gas (arrowheads) in the adjacent right hepatic lobe at the level of the ulcer defect. Arrows indicate the thickened duodenal bulbar wall. Since the patient was not a candidate for surgical intervention she was treated conservatively with IV antibiotics.', 'hash': '05899e4ccfd24189596671da8a96e4b0834ea73b7e12699b4157cb1c95929f5f'}, {'image_id': 'gr20_lrg', 'image_file_name': 'gr20_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr20_lrg.jpg', 'caption': '67-year-old man hospitalized with COVID-19 requiring ventilation who developed acute kidney injury, nausea and abdominal distension with a tender abdomen and peritoneal signs on physical exam on day three of his hospital course. (a) Supine scout from CT shows dilated small bowel in the left mid abdomen and bibasilar interstitial infiltrates. (b,c) Axial and coronal contrast-enhanced CT images show dilated proximal and mid small bowel loops (arrows) with non-distended distal small bowel and small amount of colonic air with no discrete transition zone. Findings are most suggestive of a severe ileus pattern, somewhat mimicking a small bowel obstruction. Exploratory laparotomy was performed revealing a friable mesentery with several areas of ecchymosis, dilated, hyperemic, thickened and dusky small bowel. The abdomen was left open. No obstruction was found and findings were deemed to be secondary to COVID-19 related ischemia. Re-exploration 10\xa0days later revealed normal small bowel and resolution of ileus. The patient improved and was later discharged to rehabilitation center.', 'hash': '9e009924bbb9d1fbb5722693714a2f70c591a015eda8041bdd29c05f14609f41'}, {'image_id': 'gr16_lrg', 'image_file_name': 'gr16_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr16_lrg.jpg', 'caption': '71-year-old woman from a nursing home with history of dementia, schizophrenia and obstructive sleep apnea, found to be COVID-19 positive and presented to the Emergency Room unresponsive and with acute kidney injury. Axial contrast-enhanced CT image shows a hypodense filling defect distending the left renal vein consistent with non-occlusive renal vein thrombus (arrow).', 'hash': '02879400c43207772939f1f5ebc98728df1bf34f27d9249684d82a27f737d53b'}, {'image_id': 'gr12_lrg', 'image_file_name': 'gr12_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr12_lrg.jpg', 'caption': '68-year-old woman with history of diabetes, hypertension and asthma presented to the hospital with COVID-19 pneumonia and elevated creatinine due to acute kidney injury. (a,b) Sagittal gray-scale ultrasound images of the right and left kidneys show increased renal parenchymal echogenicity and loss of corticomedullary differentiation with preserved cortical thickness.', 'hash': '8197c6cca81a77c37ead7589624c087cf65b00b8f1ea04b05f0f3b68166f5b5b'}, {'image_id': 'gr31_lrg', 'image_file_name': 'gr31_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr31_lrg.jpg', 'caption': '13-year-old boy with MIS-C who presented with abdominal pain, vomiting, diarrhea, fever, hypotension and elevated liver function tests. (a) Coronal contrast-enhanced CT image demonstrates mural thickening of the ascending colon (arrows) and terminal ileum (TI). Gallbladder wall thickening is noted. (b) Coronal image in a more posterior location shows a chain of enlarged mesenteric lymph nodes (thin arrows), with hazy infiltration of the mesentery (arrowheads). There is also small pelvic ascites (thick arrows).', 'hash': 'ec979299c5c28f28cad8fb85f0495ae7292944b19683bb469ca2d97e286776d7'}, {'image_id': 'gr3_lrg', 'image_file_name': 'gr3_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr3_lrg.jpg', 'caption': '65-year-old woman with COVID-19 and elevated liver enzymes due to hepatic steatosis. (a) Axial non-enhanced CT image shows diffuse hypoattenuation of the liver whose attenuation was greater than 10 HU lower than the spleen. (b) Subsequent contrast-enhanced CT images shows marked hypoattenuation of the liver whose attenuation was greater than 30 HU lower than the spleen.', 'hash': 'b547a7fbbc5c6deb64a9a0b13d812f577c6c19b241ff672ef2fcce94b5e6130b'}, {'image_id': 'gr7_lrg', 'image_file_name': 'gr7_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr7_lrg.jpg', 'caption': "77-year-old man with rising bilirubin, fever and abdominal pain, with concern for acalculous cholecystitis. Sagittal gray-scale ultrasound image shows gallbladder distension and sludge (arrow). Findings were attributed to biliary stasis and not acalculous cholecystitis due to lack of mural thickening, hyperemia and sonographic Murphy's sign.", 'hash': 'b9cb33be4b612a5e3866ecd15a158ce97854fa76537fd65cecb7c1fb1d9e794b'}, {'image_id': 'gr26_lrg', 'image_file_name': 'gr26_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr26_lrg.jpg', 'caption': 'Chest radiographs in two patients with MIS-C. 9-year-old girl with previously healthy girl who presented with cardiogenic shock and acute renal failure. Frontal chest radiograph shows symmetric hazy airspace opacities, increased interstitial markings, and bilateral small pleural effusions.', 'hash': '67ca6ec751c74d1e75ef266adf9e1b8d61c77912f79cbfb4026c01c598ce9d40'}, {'image_id': 'gr22_lrg', 'image_file_name': 'gr22_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr22_lrg.jpg', 'caption': '67-year-old man with stage III colon cancer hospitalized for COVID-19 pneumonia requiring mechanical ventilation for worsening respiratory distress. (a) Portable chest radiograph shows bilateral infiltrates consistent with pneumonia, with subcutaneous emphysema in the right axilla and neck (asterisk), pneumoperitoneum under the right hemidiaphragm (arrowheads), and small pneumomediastinum (arrows). Bilateral cervical central lines and endotracheal tube are present. (b) Subsequent non-contrast CT image performed with oral contrast via a nasogastric tube showed no extravasation of oral contrast. Pneumoperitoneum ventral to the liver (arrow) and tracking along the gastrohepatic ligament and subjacent left precrural retroperitoneum (arrowheads) is noted. (c) More caudal CT image shows continuous tracking of retroperitoneal gas in the left retroperitoneum (arrowheads) anterior to the left psoas and in the left posterior pararenal space and left paracolic gutter. Small foci of extraluminal gas are visible in the right anterior abdomen. (d) Coronal CT image of the chest, abdomen and pelvis with lung windows shows the tracking nature of the pneumomediastial air (arrowheads) coursing below the diaphragm (black arrows) into the left retroperitoneum and left paracolic gutter. Subcutaneous emphysema in the right axilla is noted (black asterisk). Bilateral pneumonia is noted and the nasogastric is partially visualized.', 'hash': 'ee1f7c6af23712a4c5cf88f816abfd1a83a776aba96d101bcf802ca7db8a01e7'}, {'image_id': 'gr14_lrg', 'image_file_name': 'gr14_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr14_lrg.jpg', 'caption': '63-year-old man with past medical history of diabetes and hypertension, presented with COVID-19 pneumonia and two days of dysuria and hematuria. (a) Axial and (b) coronal contrast-enhanced CT images demonstrate marked mural thickening of the urinary bladder with mild adjacent perivesicular stranding. The patient has a penile prosthesis with a reservoir (asterisk) in the right anterior pelvis.', 'hash': 'bb9aa0b224ffc5488ee6dfbc0d385ced6ade1f5a78a682b7a1457af9c816b378'}, {'image_id': 'gr10_lrg', 'image_file_name': 'gr10_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr10_lrg.jpg', 'caption': '57-year-old woman with history of coronary artery disease, chronic kidney disease and COVID-19 pneumonia who developed abdominal pain and an elevated lipase. Axial T2-weighted image with fat saturation reveals hyperintense edema and fluid surrounding the pancreas (arrowheads), trace perihepatic and left perirenal ascites, and gallbladder sludge (arrow). No gallstones were seen on ultrasound (not shown).', 'hash': 'ee134a00c5c2e7d03bb99dd0707852c4a350e9a4d8663568ea798466329f8728'}, {'image_id': 'gr18_lrg', 'image_file_name': 'gr18_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr18_lrg.jpg', 'caption': '69-year-old man with history of atrial fibrillation hospitalized with COVID-19 pneumonia that developed a cerebrovascular attack in the ICU and required intubation for respiratory compromise. Prior to PEG placement CT of the abdomen and pelvis was performed to assess his anatomy. Axial contrast-enhanced CT image demonstrates a large wedge-shaped non-enhancing splenic infarct (asterisk) and diffuse hypodense filling defect in the splenic artery (arrows) consistent with thrombus. Enhancing splenic vein is noted (arrowhead). The patient did not survive.', 'hash': '37a4050a7672a9dcbf72c3b56f0ce4dd01dad2de3d862cd519e9428cb8048903'}, {'image_id': 'gr32_lrg', 'image_file_name': 'gr32_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr32_lrg.jpg', 'caption': '18-year-old man with MIS-C who presented with headache, right lower quadrant abdominal pain and elevated inflammatory markers. (a) Sagittal gray-scale ultrasound image of the right lower quadrant demonstrates wall thickening of the ascending colon and cecum (arrows). (b) Coronal contrast-enhanced CT image confirms moderate wall thickening of the right colon (arrows) and thickening of the terminal ileum (arrowhead).', 'hash': 'fa1a8b7331009b8ecee932061ac90fea506a61b10fa5d9204cba1f626a99ebe7'}, {'image_id': 'gr19_lrg', 'image_file_name': 'gr19_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr19_lrg.jpg', 'caption': '72-year-old woman in the Emergency Room with weakness, nausea and abdominal pain who tested positive for SARS-CoV-2. Supine portable radiograph shows mild prominence of air-filled small bowel that is minimally distended and mild prominence of non-dilated segments of colon consistent with ileus. No further imaging was performed. The patient was treated conservatively with supportive therapy and discharged 3\xa0days later.', 'hash': '95766775095e492440b014be168220f41e6dc38494ca6b5e15da5ff56efe5823'}, {'image_id': 'gr15_lrg', 'image_file_name': 'gr15_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr15_lrg.jpg', 'caption': "69-year-old woman with history of hypertension, coronary artery disease and congestive heart failure presented to the Emergency Room with cough and chest tightness. She was diagnosed with COVID-19 pneumonia and found to have acute kidney injury. (a) Coronal contrast-enhanced CT image shows multiple wedge-shaped non-enhancing defects in the left kidney (arrowheads). Also seen is perinephric fat stranding around the right kidney with thickening of the adjacent Gerota's fascia (arrows). (b) A more anterior coronal contrast-enhanced CT image shows a focal hypodense filling defect in the proximal left renal artery (arrow) consistent with thrombus.", 'hash': 'd0c94f6686d1da0fbf90ec5b370d19f4b25cd35b0a8ecf164bbc20001f41ae13'}, {'image_id': 'gr11_lrg', 'image_file_name': 'gr11_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr11_lrg.jpg', 'caption': '44-year-old man with diabetes and mild obesity hospitalized with COVID-pneumonia who developed acute kidney injury requiring dialysis and acute respiratory distress syndrome. His liver enzymes and lipase levels increased. Right upper quadrant ultrasound and non-contrast CT of the abdomen and pelvis were notable for increased hepatic and renal echogenicity (not shown). Balanced Turbo Field Echo (BTFE) axial MRI image shows mild T2 hyperintense stranding of the peripancreatic fat (arrowheads) surrounding the pancreatic tail. Mild hepatic steatosis was also present (not shown).', 'hash': '3e9bccbb9d7a7e8e440a3c60e230f82c2abc568a9775a04e045a81e6f57072bb'}, {'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr2_lrg.jpg', 'caption': '68-year-old woman with COVID pneumonia and newly elevated liver function tests. Sagittal gray-scale ultrasound image shows increased hepatic echogenicity with poor acoustic penetration and contrasting hypoechogenic appearance of the right kidney compatible with steatosis, without hepatomegaly. Gallbladder (not shown) is normal.', 'hash': '919f32ed7dcab7c0cc70cce230b0e9ff183790af54ec08ffed1a369273aec919'}, {'image_id': 'gr6_lrg', 'image_file_name': 'gr6_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr6_lrg.jpg', 'caption': '73-year-old obese woman with COVID-19 pneumonia and increasing liver function tests. (a) Axial contrast-enhanced CT image shows hypodense thrombus in the medial segmental branch of the left portal vein (arrow). (b) Corresponding image from an older exam demonstrates the branch to be patent (arrow).', 'hash': '1aac3fdabfcbbb8c8ab8cf29beaaa6f82d80d1962ec6bf5a2c0d237edf4ed17c'}, {'image_id': 'gr27_lrg', 'image_file_name': 'gr27_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr27_lrg.jpg', 'caption': 'Chest radiographs in two patients with MIS-C. 9-year-old boy with history of asthma, who presented with high fever, rash and abdominal pain. Frontal chest radiographs shows mild cardiomegaly and bilateral symmetric central consolidative airspace opacities.', 'hash': '700ee60735ae757d16c2ad60cc86818ccdce6c3642e6578888d6f57212e44262'}, {'image_id': 'gr23_lrg', 'image_file_name': 'gr23_lrg.jpg', 'image_path': '../data/media_files/PMC8223038/gr23_lrg.jpg', 'caption': '73-year-old woman found collapsed in her home was brought to the Emergency Room for abdominal pain and shortness of breath due to COVID-19 pneumonia. Non-contrast CT scan of the chest, abdomen and pelvis revealed multifocal pneumonia in the lung bases (not shown), moderate upper abdominal pneumoperitoneum (arrows) and moderate ascites with mild mesenteric and subcutaneous edema. The underlying duodenal bulbar region (*) is surrounded by free air. Exploratory laparotomy revealed a 1\xa0cm anterior bulbar perforation that was repaired.', 'hash': '77f0ee3b4c360483da1a5862b9e485188512b90a3eb56571dda19b459c7c3b91'}] | {'gr1_lrg': ['On imaging the liver may be enlarged. On ultrasound, the liver of patients with abnormal liver function tests may be coarsened and/or increased in echogenicity (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, , <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>\n). On CT scan, the liver may be hypoattenuated on non-contrast or contrast-enhanced exam due to steatosis (\n). On CT scan, the liver may be hypoattenuated on non-contrast or contrast-enhanced exam due to steatosis (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>\n). Periportal edema and heterogeneity of hepatic enhancement may be seen on contrast-enhanced CT or MRI due to parenchymal inflammation. On MRI, loss of signal on opposed-phase sequences (\n). Periportal edema and heterogeneity of hepatic enhancement may be seen on contrast-enhanced CT or MRI due to parenchymal inflammation. On MRI, loss of signal on opposed-phase sequences (<xref rid="gr4_lrg" ref-type="fig">Fig. 4</xref>\n) may be seen due to steatosis and periportal edema may be conspicuous on T2-weighted images or on contrast-enhanced images [\n) may be seen due to steatosis and periportal edema may be conspicuous on T2-weighted images or on contrast-enhanced images [7,8,14]. Periportal lymphadenopathy, typical of chronic liver disease, is not reported in COVID-19 [8]. In patients with severe COVID-19 infection, ancillary manifestations of hepatic inflammation and injury, such as parenchymal attenuation changes and abscesses may be seen (<xref rid="gr5_lrg" ref-type="fig">Fig. 5</xref>\n).\n).Fig. 140-year-old man with COVID-19 pneumonia and no known liver disease with increasing liver function tests. (1a) Sagittal gray-scale ultrasound image demonstrates increased liver echogenicity, consistent with steatosis without hepatomegaly. (1b) Sagittal gray-scale ultrasound image shows a normal gallbladder (arrow) and no biliary dilatation (not shown).Fig. 1Fig. 268-year-old woman with COVID pneumonia and newly elevated liver function tests. Sagittal gray-scale ultrasound image shows increased hepatic echogenicity with poor acoustic penetration and contrasting hypoechogenic appearance of the right kidney compatible with steatosis, without hepatomegaly. Gallbladder (not shown) is normal.Fig. 2Fig. 365-year-old woman with COVID-19 and elevated liver enzymes due to hepatic steatosis. (a) Axial non-enhanced CT image shows diffuse hypoattenuation of the liver whose attenuation was greater than 10 HU lower than the spleen. (b) Subsequent contrast-enhanced CT images shows marked hypoattenuation of the liver whose attenuation was greater than 30 HU lower than the spleen.Fig. 3Fig. 4Hepatic steatosis in a 44\xa0year old male with COVID-19 and elevated liver enzymes.(a) Axial in and (b) out-of-phase MRI images show loss of signal in the liver parenchyma on the out of phase sequence consistent with intracellular fat. Note focal high signal due to fatty sparing in the medial segment of the left lobe (arrow).Fig. 4Fig. 549-year-old man with COVID-19 pneumonia who has a history of coronary artery disease and diabetes mellitus. (a) Axial contrast-enhanced CT image shows hypodense thrombus in the distal right portal vein (arrow) extending into the posterior segmental branch (arrowhead) with associated heterogeneous right lobe enhancement. (b) Sagittal Color Doppler US image shows absent flow and no spectral waveform consistent with occlusive thrombus. (c) More cephalic image shows heterogenous hepatic enhancement with several rounded hypoattenuated foci consistent with parenchymal inflammation and abscesses. The patient was treated with anticoagulation and antibiotics. (d,e) Axial contrast-enhanced CT images 3\xa0months later shows gross resolution of abscesses with persistent geographic hypoattenuation due to perfusion change (arrowheads) with only slight decrease in right portal vein thrombosis (arrow).Fig. 5'], 'gr6_lrg': ['On ultrasound, portal vein thrombosis appears as echogenic material within the vein, although it may be anechoic and undetectable in the early acute stages. Color Doppler images may show total or partial absence of flow in the vein. On contrast-enhanced CT or MRI, portal vein thrombosis appears as non-enhancing filling defect within the main or intrahepatic branches (<xref rid="gr6_lrg" ref-type="fig">Fig. 6</xref>\n). Clots may be occlusive or non-occlusive and may expand the involved vein.\n). Clots may be occlusive or non-occlusive and may expand the involved vein.Fig. 673-year-old obese woman with COVID-19 pneumonia and increasing liver function tests. (a) Axial contrast-enhanced CT image shows hypodense thrombus in the medial segmental branch of the left portal vein (arrow). (b) Corresponding image from an older exam demonstrates the branch to be patent (arrow).Fig. 6'], 'gr7_lrg': ['On imaging, biliary stasis may manifest as increased gallbladder distention (typically defined as >/=5\xa0cm) and sludge, and acalculous cholecystitis is suggested when there is superimposed gallbladder mural thickening and pericholecystic fluid [20] (<xref rid="gr7_lrg" ref-type="fig">Fig. 7</xref>\n). Prolonged biliary stasis may obstruct the biliary tree and result in cholangitis. This is demonstrated on imaging as extrahepatic or intrahepatic biliary ductal dilatation, and increased biliary ductal mural thickening and enhancement (\n). Prolonged biliary stasis may obstruct the biliary tree and result in cholangitis. This is demonstrated on imaging as extrahepatic or intrahepatic biliary ductal dilatation, and increased biliary ductal mural thickening and enhancement (<xref rid="gr8_lrg" ref-type="fig">Fig. 8</xref>\n). Gallstones should be excluded on ultrasound, as choledocholithiasis is a more common cause of biliary infection.\n). Gallstones should be excluded on ultrasound, as choledocholithiasis is a more common cause of biliary infection.Fig. 777-year-old man with rising bilirubin, fever and abdominal pain, with concern for acalculous cholecystitis. Sagittal gray-scale ultrasound image shows gallbladder distension and sludge (arrow). Findings were attributed to biliary stasis and not acalculous cholecystitis due to lack of mural thickening, hyperemia and sonographic Murphy\'s sign.Fig. 7Fig. 854-year-old man with COVID-19 with history of obesity and diabetes mellitus. (a,b) Axial and coronal contrast-enhanced CT images show mild dilatation (8\xa0mm) and mural hyperenhancement of the common bile duct (arrow). Ultrasound (not shown) shows absence of gallstones. (c,d) Axial and coronal images from CT from 1-year prior show a normal common bile duct (arrow).Fig. 8'], 'gr9_lrg': ['The management of acute cholecystitis in COVID-19 patients is controversial. Intravenous antibiotics alone or with percutaneous cholecystostomy are advocated by many as a bridging agent to cholecystectomy [22] [<xref rid="gr9_lrg" ref-type="fig">Fig. 9</xref>\n]. Since it remains unknown the extent to which SARS-CoV-2 remains in the smoke generated by electrocautery [\n]. Since it remains unknown the extent to which SARS-CoV-2 remains in the smoke generated by electrocautery [23], some recommend conservative management [24]. Others advocate an individualized approach based on the severity of cholecystitis and available resources during the pandemic [25].Fig. 960-year-old man with history of hypertension and asthma hospitalized for COVID-19 pneumonia with respiratory distress requiring oxygen supplementation and with diffuse abdominal pain and leukocytosis. (a) Axial CT image with lung windows shows bibasilar infiltrates. (b,c) Axial and coronal contrast-enhanced CT images show a hydropic gallbladder with stones (arrow). Hepatobiliary iminodiacetic acid (HIDA) scan was positive confirming acute cholecystitis. Percutaneous cholecystostomy was performed with clear yellow bile drained. Cholecystectomy was performed 4\xa0weeks later revealing chronic cholecystitis and stones. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)Fig. 9'], 'gr10_lrg': ['Imaging findings of pancreatitis in COVID-19 patients mimic those in other settings, with CT demonstrating diffuse or focal pancreatic enlargement, decreased pancreatic attenuation due to edema, surrounding fat stranding and indistinct gland margins. MRI shows similar manifestations, with the gland appearing enlarged with poorly defined margins, and with edema and free fluid appearing bright on T2 weighted images (<xref rid="gr10_lrg" ref-type="fig">Fig. 10</xref>, , <xref rid="gr11_lrg" ref-type="fig">Fig. 11</xref>\n).\n).Fig. 1057-year-old woman with history of coronary artery disease, chronic kidney disease and COVID-19 pneumonia who developed abdominal pain and an elevated lipase. Axial T2-weighted image with fat saturation reveals hyperintense edema and fluid surrounding the pancreas (arrowheads), trace perihepatic and left perirenal ascites, and gallbladder sludge (arrow). No gallstones were seen on ultrasound (not shown).Fig. 10Fig. 1144-year-old man with diabetes and mild obesity hospitalized with COVID-pneumonia who developed acute kidney injury requiring dialysis and acute respiratory distress syndrome. His liver enzymes and lipase levels increased. Right upper quadrant ultrasound and non-contrast CT of the abdomen and pelvis were notable for increased hepatic and renal echogenicity (not shown). Balanced Turbo Field Echo (BTFE) axial MRI image shows mild T2 hyperintense stranding of the peripancreatic fat (arrowheads) surrounding the pancreatic tail. Mild hepatic steatosis was also present (not shown).Fig. 11'], 'gr12_lrg': ['On ultrasound, the kidneys of COVID-19 patients with AKI typically demonstrate increased or heterogeneous parenchymal echogenicity, with possible loss of corticomedullary differentiation [7] [<xref rid="gr12_lrg" ref-type="fig">Fig. 12</xref>\n]. Involved kidneys typically have preserved cortical thickness, which helps differentiate them from those with chronic kidney disease. Additionally, a combination of nonspecific findings including increased renal parenchymal echogenicity, loss of corticomedullary differentiation, increased resistive indices and decreased color Doppler flow can be seen in COVID-19 patients with collapsing focal segmental glomerulosclerosis [\n]. Involved kidneys typically have preserved cortical thickness, which helps differentiate them from those with chronic kidney disease. Additionally, a combination of nonspecific findings including increased renal parenchymal echogenicity, loss of corticomedullary differentiation, increased resistive indices and decreased color Doppler flow can be seen in COVID-19 patients with collapsing focal segmental glomerulosclerosis [33]. On non-contrast CT, perinephric fat stranding and thickening of Gerota\'s fascia correlated with higher serum creatinine levels in patients with AKI, suggesting more severe inflammation and parenchymal injury [34]. Following the administration of contrast, geographic hypodense areas maybe observed in the periphery of the kidneys from hypoperfusion attributed to vasculopathy [35] [<xref rid="gr13_lrg" ref-type="fig">Fig. 13</xref>\n].\n].Fig. 1268-year-old woman with history of diabetes, hypertension and asthma presented to the hospital with COVID-19 pneumonia and elevated creatinine due to acute kidney injury. (a,b) Sagittal gray-scale ultrasound images of the right and left kidneys show increased renal parenchymal echogenicity and loss of corticomedullary differentiation with preserved cortical thickness.Fig. 12Fig. 1365-year-old woman with COVID-19 pneumonia presented with elevated creatinine and acute kidney injury. Her past medical history was notable for hypertension and remote history of breast cancer. (a) Axial and (b) coronal contrast-enhanced CT images show patchy mottled inhomogeneous renal enhancement of both kidneys that are of normal size.Fig. 13'], 'gr14_lrg': ['Imaging findings include diffuse and irregular bladder wall thickening on ultrasound and diffuse thickening and enhancement of the bladder wall on CT, with adjacent perivesicular stranding [7,39] [<xref rid="gr14_lrg" ref-type="fig">Fig. 14</xref>\n].\n].Fig. 1463-year-old man with past medical history of diabetes and hypertension, presented with COVID-19 pneumonia and two days of dysuria and hematuria. (a) Axial and (b) coronal contrast-enhanced CT images demonstrate marked mural thickening of the urinary bladder with mild adjacent perivesicular stranding. The patient has a penile prosthesis with a reservoir (asterisk) in the right anterior pelvis.Fig. 14'], 'gr15_lrg': ['On ultrasound, renal infarcts appear as wedge shaped heterogeneous hypoechoic areas with decreased or absent perfusion on color Doppler images [7]. On CT and MRI, renal infarcts may appear as geographic focal or multifocal areas of diminished or absent parenchymal enhancement in one or both kidneys. The renal defects are typically wedge-shaped spanning the cortex and medulla with their apex towards the hilum and extending to the renal capsule. Several days after acute onset they typically have overlying thin capsular enhancement (“rim sign”) due to preserved collateral capsular perfusion. Segmental infarcts have a characteristic geographic appearance that follows the distribution of the anterior and posterior branch vessels of the renal artery [50]. On MRI, infarcts vary with age and are usually hypointense on T1-weighted and T2-weighted images acutely, becoming higher in signal on T2-weighted images over the next few days as coagulation necrosis occurs. They may appear hyperintense on T1-weighted images if hemorrhage occurs. Healed or chronic infarcts have progressively decreased signal due to fibrosis and atrophy. There is often loss of normal corticomedullary differentiation in the infarcted segment and corresponding wedge-shaped areas of hypoennhancement on post contrast images [51]. Less commonly, a filling defect may be seen in the renal artery on post-contrast images [<xref rid="gr15_lrg" ref-type="fig">Fig. 15</xref>\n] or vein [\n] or vein [<xref rid="gr16_lrg" ref-type="fig">Fig. 16</xref>\n].\n].Fig. 1569-year-old woman with history of hypertension, coronary artery disease and congestive heart failure presented to the Emergency Room with cough and chest tightness. She was diagnosed with COVID-19 pneumonia and found to have acute kidney injury. (a) Coronal contrast-enhanced CT image shows multiple wedge-shaped non-enhancing defects in the left kidney (arrowheads). Also seen is perinephric fat stranding around the right kidney with thickening of the adjacent Gerota\'s fascia (arrows). (b) A more anterior coronal contrast-enhanced CT image shows a focal hypodense filling defect in the proximal left renal artery (arrow) consistent with thrombus.Fig. 15Fig. 1671-year-old woman from a nursing home with history of dementia, schizophrenia and obstructive sleep apnea, found to be COVID-19 positive and presented to the Emergency Room unresponsive and with acute kidney injury. Axial contrast-enhanced CT image shows a hypodense filling defect distending the left renal vein consistent with non-occlusive renal vein thrombus (arrow).Fig. 16'], 'gr17_lrg': ['On CT and MRI, splenic infarcts appear as single or multiple peripheral wedge-shaped hypoenhancing defects, with their apex pointed towards the hilum [<xref rid="gr17_lrg" ref-type="fig">Fig. 17</xref>\n]. They can also be rounded or linear in shape. Their appearance varies with age, being vague hypodense areas on CT with mottled enhancement in the first 24\xa0h, and becoming progressively better defined non-enhancing hypodense defects over the next week [\n]. They can also be rounded or linear in shape. Their appearance varies with age, being vague hypodense areas on CT with mottled enhancement in the first 24\xa0h, and becoming progressively better defined non-enhancing hypodense defects over the next week [55]. On MRI, splenic infarcts are typically hypointense on T1- and T2-weighted images without enhancement on the post contrast images. However, their appearance varies based on the presence of hemorrhage and with their age. Acute and hemorrhagic infarcts are hyperintense on T1-weighted images and hypointense on T2-weighted images. Subacute infarcts have fluid signal. Chronic infarcts may fully resolve or become hypointense on T2 and T2-weighted images [56,57]. Less commonly, a filling defect may be seen in the splenic vein or artery on post-contrast images [<xref rid="gr18_lrg" ref-type="fig">Fig. 18</xref>\n].\n].Fig. 1758-year-old male with history of hypertension and diabetes presented to the Emergency Room with worsening abdominal pain who tested positive for SARS-CoV2 1\xa0week ago and lacked respiratory symptoms. (a) Axial and (b) coronal contrast-enhanced CT demonstrates multiple geographic wedge shaped non-enhancing splenic defects (arrowheads). (c) Axial contrast-enhanced CT 4\xa0months later shows small linear band like areas of hypoattenuation with overlying capsular retraction consistent with scarring (arrowheads).Fig. 17Fig. 1869-year-old man with history of atrial fibrillation hospitalized with COVID-19 pneumonia that developed a cerebrovascular attack in the ICU and required intubation for respiratory compromise. Prior to PEG placement CT of the abdomen and pelvis was performed to assess his anatomy. Axial contrast-enhanced CT image demonstrates a large wedge-shaped non-enhancing splenic infarct (asterisk) and diffuse hypodense filling defect in the splenic artery (arrows) consistent with thrombus. Enhancing splenic vein is noted (arrowhead). The patient did not survive.Fig. 18'], 'gr19_lrg': ['Ileus can manifest as gaseous distention of the small bowel, colon or both and is relatively common in hospitalized COVID-19 patients (<xref rid="gr19_lrg" ref-type="fig">Fig. 19</xref>\n). Kaafarani et al. reported that 56% of patients in their case series of 141 patients with severe COVID-19 requiring ICU care had a clinical or radiographic diagnosis of ileus [\n). Kaafarani et al. reported that 56% of patients in their case series of 141 patients with severe COVID-19 requiring ICU care had a clinical or radiographic diagnosis of ileus [60]. The pathophysiology of ileus in COVID-19 is likely multifactorial. In severely ill COVID-19 patients, ileus is commonly caused by metabolic and/or electrolyte derangements but may also be reactive to other complications of COVID-19 [60,68] or due to direct viral entry into enterocytes with resultant intestinal inflammation and ensuing ileus [68]. A few cases of severe colonic ileus have been reported in patients with severe pulmonary COVID-19 infection [68,69], some of which were complicated by bowel ischemia [68,69] and some of which were indistinguishable from Ogilvie syndrome [69].Fig. 1972-year-old woman in the Emergency Room with weakness, nausea and abdominal pain who tested positive for SARS-CoV-2. Supine portable radiograph shows mild prominence of air-filled small bowel that is minimally distended and mild prominence of non-dilated segments of colon consistent with ileus. No further imaging was performed. The patient was treated conservatively with supportive therapy and discharged 3\xa0days later.Fig. 19'], 'gr20_lrg': ['Imaging findings of COVID-19 related bowel ischemia on CT angiogram of the abdomen and pelvis are not unique and include mural thickening, a targetoid mural enhancement pattern, absent or diminished mural enhancement, mural hyperenhancement, ileus [<xref rid="gr20_lrg" ref-type="fig">Fig. 20</xref>\n], mesenteric vascular engorgement, mesenteric fat stranding and ascites. Pneumatosis and/or portomesenteric venous gas may reflect ischemia or infarction, but when seen together typically indicate infarction [\n], mesenteric vascular engorgement, mesenteric fat stranding and ascites. Pneumatosis and/or portomesenteric venous gas may reflect ischemia or infarction, but when seen together typically indicate infarction [74,75] [<xref rid="gr21_lrg" ref-type="fig">Fig. 21</xref>\n]. Arterial filling defects or zones of vascular narrowing may occur in arterial ischemia with preservation or thinning of bowel wall thickness. Venous filling defects may occur in venous ischemia typically with associated mesenteric venous engorgement, mural thickening and ascites. In nonocclusive mesenteric ischemia, bowel wall may be normal or thickened due to reperfusion. Mesenteric fat stranding and ascites are also common [\n]. Arterial filling defects or zones of vascular narrowing may occur in arterial ischemia with preservation or thinning of bowel wall thickness. Venous filling defects may occur in venous ischemia typically with associated mesenteric venous engorgement, mural thickening and ascites. In nonocclusive mesenteric ischemia, bowel wall may be normal or thickened due to reperfusion. Mesenteric fat stranding and ascites are also common [74].Fig. 2067-year-old man hospitalized with COVID-19 requiring ventilation who developed acute kidney injury, nausea and abdominal distension with a tender abdomen and peritoneal signs on physical exam on day three of his hospital course. (a) Supine scout from CT shows dilated small bowel in the left mid abdomen and bibasilar interstitial infiltrates. (b,c) Axial and coronal contrast-enhanced CT images show dilated proximal and mid small bowel loops (arrows) with non-distended distal small bowel and small amount of colonic air with no discrete transition zone. Findings are most suggestive of a severe ileus pattern, somewhat mimicking a small bowel obstruction. Exploratory laparotomy was performed revealing a friable mesentery with several areas of ecchymosis, dilated, hyperemic, thickened and dusky small bowel. The abdomen was left open. No obstruction was found and findings were deemed to be secondary to COVID-19 related ischemia. Re-exploration 10\xa0days later revealed normal small bowel and resolution of ileus. The patient improved and was later discharged to rehabilitation center.Fig. 20Fig. 2161-year-old man with no significant past medical history in the ICU for one month for respiratory failure due to COVID-19 pneumonia underwent CT scan of the chest, abdomen and pelvis because of persistent fever and leukocytosis despite broad spectrum antibiotics. (a) Supine scout shows bilateral interstitial infiltrates and marked colonic ileus. (b) Axial contrast-enhanced CT image shows portal venous gas (arrow) in the periphery of the left hepatic lobe. (c) Coronal CT images shows pneumatosis of the entire right colon (arrow) and a distal ileal loop (arrowhead) with mild mesenteric haziness. (d) Axial CT image shows extensive distal ileal pneumatosis (arrowhead) with adjacent branching mesenteric venous gas (thin arrows). Despite the findings of bowel ischemia, due to the patient\'s advanced septic condition, he was not a surgical candidate and died the following day. Additional imaging during his hospital course confirmed evidence of acute kidney injury with (e) longitudinal ultrasound image of his left kidney showing increased cortical echogenicity with increased conspicuity of the pyramids (arrowheads). He also had signs of liver injury with rising liver function tests and (f) longitudinal ultrasound image of the right hepatic lobe showing increased echogenicity suggestive of steatosis.Fig. 21'], 'gr22_lrg': ['Pneumoperitoneum in hospitalized COVID-19 patients has many causes including recent surgery, iatrogenic procedural trauma, bowel perforation, ischemia, and benign causes such as barotrauma in ventilated patients. Benign pneumomediastinum and pneumoperitoneum can be due to pulmonary interstitial emphysema, known as the Macklin effect [80]. In the setting of barotrauma, typically due to invasive mechanical ventilation, alveoli can rupture leading to small pockets of air tracking along the peribronchovascular sheaths into the mediastinum. Once air collects within the mediastinum, it can dissect into the peritoneal cavity, causing pneumoperitoneum via major diaphragmatic portals [<xref rid="gr22_lrg" ref-type="fig">Fig. 22</xref>\n]. Alternatively, even if pneumomediastinum is absent, air can track directly through pleural or diaphragmatic defects leading to isolated pneumoperitoneum [\n]. Alternatively, even if pneumomediastinum is absent, air can track directly through pleural or diaphragmatic defects leading to isolated pneumoperitoneum [81]. Duarte et al. report a case of pneumoperitoneum in a hospitalized COVID-19 patient who developed pulmonary interstitial edema from nasal cannula oxygen supplementation leading to benign pneumoperitoneum [81]. Intrathoracic barotrauma has been reported in 15% of COVID-19 patients on assisted mechanical ventilation and is more likely to occur in younger patients [82].Fig. 2267-year-old man with stage III colon cancer hospitalized for COVID-19 pneumonia requiring mechanical ventilation for worsening respiratory distress. (a) Portable chest radiograph shows bilateral infiltrates consistent with pneumonia, with subcutaneous emphysema in the right axilla and neck (asterisk), pneumoperitoneum under the right hemidiaphragm (arrowheads), and small pneumomediastinum (arrows). Bilateral cervical central lines and endotracheal tube are present. (b) Subsequent non-contrast CT image performed with oral contrast via a nasogastric tube showed no extravasation of oral contrast. Pneumoperitoneum ventral to the liver (arrow) and tracking along the gastrohepatic ligament and subjacent left precrural retroperitoneum (arrowheads) is noted. (c) More caudal CT image shows continuous tracking of retroperitoneal gas in the left retroperitoneum (arrowheads) anterior to the left psoas and in the left posterior pararenal space and left paracolic gutter. Small foci of extraluminal gas are visible in the right anterior abdomen. (d) Coronal CT image of the chest, abdomen and pelvis with lung windows shows the tracking nature of the pneumomediastial air (arrowheads) coursing below the diaphragm (black arrows) into the left retroperitoneum and left paracolic gutter. Subcutaneous emphysema in the right axilla is noted (black asterisk). Bilateral pneumonia is noted and the nasogastric is partially visualized.Fig. 22'], 'gr23_lrg': ['Dedicated CT angiogram with a GI bleeding protocol, including non-contrast, arterial and portal venous phase images can detect foci of active bleeding at a rate of 0.3–0.5\xa0ml/min which is less sensitive than RBC scanning (0.1–0.5\xa0ml/min) but more sensitive than fluoroscopic angiography (0.5–1.0\xa0ml/min) [86]. Alternatively, on a dual energy scanner, images maybe acquired in the arterial and portal venous phase with reconstruction of a virtual non-contrast image set [86]. On non-contrast exam, luminal blood product is hyperdense with attenuations ranging from 30 to 45 HU when unclotted and from 45 to 70 HU when clotted [87,88]. Active extravasation of contrast appears as an area of intraluminal enhancement on arterial phase images that changes shape and attenuation on portal venous phase [89] (Artigas). In patients with intermittent bleeding or in stable patients with elevated creatinine, a technetium 99\xa0m (99mTc) nuclear medicine scan with a sulfur colloid or red blood cell pharmaceutical agent may be used as an alternative imaging modality. 99mTc scintigraphy has a high sensitivity but poor anatomic localization of acute GI bleed [90]. CT angiogram has the added benefit of detecting free air prompting a search for perforated gastric or duodenal ulcer as a source of GI bleed [<xref rid="gr23_lrg" ref-type="fig">Fig. 23</xref>, , <xref rid="gr24_lrg" ref-type="fig">Fig. 24</xref>\n].\n].Fig. 2373-year-old woman found collapsed in her home was brought to the Emergency Room for abdominal pain and shortness of breath due to COVID-19 pneumonia. Non-contrast CT scan of the chest, abdomen and pelvis revealed multifocal pneumonia in the lung bases (not shown), moderate upper abdominal pneumoperitoneum (arrows) and moderate ascites with mild mesenteric and subcutaneous edema. The underlying duodenal bulbar region (*) is surrounded by free air. Exploratory laparotomy revealed a 1\xa0cm anterior bulbar perforation that was repaired.Fig. 23Fig. 2482-year-old woman with chronic obstructive pulmonary disease and end-stage renal disease sent from the nursing home 4\xa0weeks after testing positive for COVID-19 with leukocytosis. (a) Axial contrast-enhanced CT image show a mildly thick-walled duodenal bulbar region (arrows) with a small anterior defect and extraluminal gas (arrowhead) consistent with locally perforated ulcer. Two small left renal cysts are present. (b) Coronal CT image shows a small walled off fluid collection with fluid and gas (arrowheads) in the adjacent right hepatic lobe at the level of the ulcer defect. Arrows indicate the thickened duodenal bulbar wall. Since the patient was not a candidate for surgical intervention she was treated conservatively with IV antibiotics.Fig. 24'], 'gr25_lrg': ['Pseudomembranous colitis should be suggested whenever abdominopelvic CT scan shows a pattern of long segment colitis [<xref rid="gr25_lrg" ref-type="fig">Fig. 25</xref>\n] most commonly involving the rectosigmoid but which can be also be segmental involving the right or transverse colon or pan-colonic in extent. It is characterized by a more extensive pattern of circumferential mural thickening than other causes of colitis, with low attenuation intramural edema, and associated features including the “accordion sign,” the “target sign,” pericolonic stranding and ascites. Mural thickening is marked with a reported mean of 15\xa0mm (range 3–32\xa0mm), and is often irregular and shaggy [\n] most commonly involving the rectosigmoid but which can be also be segmental involving the right or transverse colon or pan-colonic in extent. It is characterized by a more extensive pattern of circumferential mural thickening than other causes of colitis, with low attenuation intramural edema, and associated features including the “accordion sign,” the “target sign,” pericolonic stranding and ascites. Mural thickening is marked with a reported mean of 15\xa0mm (range 3–32\xa0mm), and is often irregular and shaggy [93].Fig. 2574-year-old morbidly obese woman with history of breast cancer and prolonged ICU hospitalization for severe COVID-19 pneumonia causing acute respiratory failure. One week after discharge to a nursing home, she was readmitted to the hospital for fever, hypotension and diarrhea. (a) Coronal non-contrast CT image with oral contrast shows prominent right and left colonic mural thickening (arrows) which involved the entire colon (not shown). (b) Axial image better shows the extent of mural thickening in the right colon (arrow) due to luminal contrast. Clostridium difficile infection was confirmed and she improved after treatment with oral Vancomycin and IV Flagyl. Her course was subsequently further complicated by gastrointestinal bleeding and retroperitoneal hemorrhage due to anticoagulation. (c) Axial non-contrast CT image shows hyperdense content expanding both psoas muscles (arrows), and in the right paracolic gutter (arrowhead).Fig. 25'], 'gr26_lrg': ['The most common respiratory complaint in MIS-C is tachypnea, although some patients may progress to respiratory failure requiring mechanical ventilation, likely secondary to shock and cardiac dysfunction [106,108,110,114]. While initial chest radiographs can be normal, as the disease progresses, common radiographic findings include bilateral diffuse airspace opacities with basilar predominance, peribronchial thickening or interstitial opacities, bilateral pleural effusions, and cardiomegaly [112,[114], [115], [116], [117]] (<xref rid="gr26_lrg" ref-type="fig">Fig. 26</xref>, , <xref rid="gr27_lrg" ref-type="fig">Fig. 27</xref>\n). The pulmonary opacities tend to be hazy and symmetric, suggesting that they reflect pulmonary edema, ARDS, and/or third spacing. These phenomena may be secondary to cardiac dysfunction, the hyperinflammatory status of the patient, or possibly even the sequelae of aggressive fluid resuscitation [\n). The pulmonary opacities tend to be hazy and symmetric, suggesting that they reflect pulmonary edema, ARDS, and/or third spacing. These phenomena may be secondary to cardiac dysfunction, the hyperinflammatory status of the patient, or possibly even the sequelae of aggressive fluid resuscitation [112,[116], [117], [118]]. Although chest radiograph findings in MIS-C can overlap with acute COVID-19 pneumonia, COVID usually presents as non-diffuse peripheral or subpleural opacities without pleural effusions and MIS-C usually presents as diffuse opacities with lower lobe predominance with pleural effusions [112,117]. It is interesting to note that patients with MIS-C may demonstrate abnormalities on chest radiographs even in the absence of lower respiratory tract symptoms [114,117].Fig. 26Chest radiographs in two patients with MIS-C. 9-year-old girl with previously healthy girl who presented with cardiogenic shock and acute renal failure. Frontal chest radiograph shows symmetric hazy airspace opacities, increased interstitial markings, and bilateral small pleural effusions.Fig. 26Fig. 27Chest radiographs in two patients with MIS-C. 9-year-old boy with history of asthma, who presented with high fever, rash and abdominal pain. Frontal chest radiographs shows mild cardiomegaly and bilateral symmetric central consolidative airspace opacities.Fig. 27'], 'gr28_lrg': ['Chest CT is not routinely performed in MIS-C, but may be indicated in patients with sepsis or suspected pulmonary embolism [114,116]. The most common chest CT findings are bibasilar consolidation with atelectasis and bilateral pleural effusions, with diffuse ground-glass opacity, septal thickening, and mild hilar lymphadenopathy less common [114] (<xref rid="gr28_lrg" ref-type="fig">Fig. 28</xref>\n).\n).Fig. 285-year-old girl with COVID-19 and MIS-C who presented with fever, conjunctivitis and vomiting. Axial chest CT image with lung (a) and soft tissue (b) windows shows mild dependent ground-glass opacities in both lungs, and bilateral small pleural effusions.Fig. 28'], 'gr29_lrg': ['Since patients with MIS-C most commonly present with gastrointestinal symptoms, often mimicking acute appendicitis, abdominal imaging is sometimes obtained even prior to recognition of the MIS-C diagnosis [98,114,128]. Commonly reported findings on abdominal radiographs, ultrasound, and CT include an ileus bowel gas pattern, mild ascites, gallbladder wall thickening, gallbladder sludge, bowel wall thickening, mesenteric lymphadenopathy, mesenteric edema or inflammatory change, and urinary bladder wall thickening [114,116,117,129] (<xref rid="gr29_lrg" ref-type="fig">Fig. 29</xref>, , <xref rid="gr30_lrg" ref-type="fig">Fig. 30</xref>, , <xref rid="gr31_lrg" ref-type="fig">Fig. 31</xref>\n). Bowel wall thickening, lymphadenopathy, and mesenteric changes can occur anywhere in the abdomen but are most commonly located in the right lower quadrant [\n). Bowel wall thickening, lymphadenopathy, and mesenteric changes can occur anywhere in the abdomen but are most commonly located in the right lower quadrant [130] (<xref rid="gr32_lrg" ref-type="fig">Fig. 32</xref>\n). A minority of patients has also demonstrated hepatosplenomegaly, splenic infarction, and increased renal echogenicity [\n). A minority of patients has also demonstrated hepatosplenomegaly, splenic infarction, and increased renal echogenicity [114,116,131]. Acute hepatitis, defined as elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, was found in 43% of subjects in a single-center report, and may account for some of the abdominal ultrasound findings in MIS-C such as hepatomegaly, gallbladder wall thickening, and ascites [132].Fig. 299-year-old girl with MIS-C who presented with abdominal pain, vomiting, fever, hypotension and acute renal failure. (a) Transverse gray-scale ultrasound image of the right upper quadrant shows mild wall thickening of the gallbladder (GB). (b) Transverse gray-scale ultrasound image of the right lower quadrant demonstrates multiple fluid-filled thick-walled loops of small bowel (*). (c) Sagittal gray-scale ultrasound image of the right lower quadrant shows multiple enlarged hypoechoic mesenteric lymph nodes (LN) lacking echogenic hila, with thickening of the surrounding fat.Fig. 29Fig. 308-year-old girl with MIS-C who presented with abdominal pain, diarrhea, fever, tachycardia and hypotension. Coronal contrast-enhanced CT image demonstrates a cluster of enlarged mesenteric lymph nodes in the right lower quadrant (arrows). There is diffuse mild fluid distention of small and large bowel consistent with ileus.Fig. 30Fig. 3113-year-old boy with MIS-C who presented with abdominal pain, vomiting, diarrhea, fever, hypotension and elevated liver function tests. (a) Coronal contrast-enhanced CT image demonstrates mural thickening of the ascending colon (arrows) and terminal ileum (TI). Gallbladder wall thickening is noted. (b) Coronal image in a more posterior location shows a chain of enlarged mesenteric lymph nodes (thin arrows), with hazy infiltration of the mesentery (arrowheads). There is also small pelvic ascites (thick arrows).Fig. 31Fig. 3218-year-old man with MIS-C who presented with headache, right lower quadrant abdominal pain and elevated inflammatory markers. (a) Sagittal gray-scale ultrasound image of the right lower quadrant demonstrates wall thickening of the ascending colon and cecum (arrows). (b) Coronal contrast-enhanced CT image confirms moderate wall thickening of the right colon (arrows) and thickening of the terminal ileum (arrowhead).Fig. 32']} | Review of COVID-19, part 1: Abdominal manifestations in adults and multisystem inflammatory syndrome in children | [
"Abdominal imaging",
"COVID-19",
"Multisystem inflammatory syndrome"
] | Clin Imaging | 1640332800 | Schistosomiasis causes significant morbidity and mortality. Vaccine efforts to date indicate the need to increase the immunogenicity of Schistosoma antigens. The multiple antigen-presenting system, whereby proteins are genetically fused to rhizavidin and affinity linked to biotinylated templates, enables the generation of robust immune responses. The objective of this work was to express and purify the S. mansoni antigens, SmTSP-2 and SmCD59.2, in fusion with rhizavidin. The fusion with rhizavidin greatly decreased the expression level of rSmTSP-2, but not rSmCD59.2, and both were expressed in the insoluble fraction, requiring optimization of culture conditions. Evaluation of different E. coli strains and media showed that BL21-DE3 cultured in Terrific Broth provided the highest expression levels of both proteins. Investigation of a range of time and temperature of induction showed that E. coli strains expressing rRzv:SmTSP-2 and rRzv:SmCD59.2 showed the highest protein production at 23 °C for 15 h. Recombinant proteins were purified by a single step of affinity chromatography allowing isolation of these proteins in high concentration and purity. The optimization process increased final soluble protein yield of rRzv:SmTSP-2 by fourfold and rRzv:SmCD59.2 by tenfold, providing ~ 20 mg/L of each protein. Optimized fusion protein production will allow antigen use in biotin-rhizavidin affinity platforms. | [
"Animals",
"Antigens, Helminth",
"Bacterial Proteins",
"Chromatography, Affinity",
"Recombinant Fusion Proteins",
"Schistosoma mansoni",
"Schistosomiasis mansoni"
] | other | PMC8223038 | null | 32 | [
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] | Clin Imaging. 2021 Dec 24; 80:88-110 | NO-CC CODE |
|
Computed tomography showing the extent of a large, left-sided Wilms tumor in a 2-year-old girl with thrombus extending the full length of the inferior vena cava (IVC) and into the right atrium (between arrows) | 467_2010_1645_Fig8_HTML | 7 | 0d6e2381f7a461ed148ea31bf244e7b3f29c118bc1fbfcef35f2edd25a8dd02b | 467_2010_1645_Fig8_HTML.jpg | multiple | multiple panels: images | [
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"computerized tomography"
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496,
467
] | [{'image_id': '467_2010_1645_Fig8_HTML', 'image_file_name': '467_2010_1645_Fig8_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig8_HTML.jpg', 'caption': 'Computed tomography showing the extent of a large, left-sided Wilms tumor in a 2-year-old girl with thrombus extending the full length of the inferior vena cava (IVC) and into the right atrium (between arrows)', 'hash': '0d6e2381f7a461ed148ea31bf244e7b3f29c118bc1fbfcef35f2edd25a8dd02b'}, {'image_id': '467_2010_1645_Fig7_HTML', 'image_file_name': '467_2010_1645_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig7_HTML.jpg', 'caption': 'Magnetic resonance imaging: gadolinium-enhanced MR angiography demonstrating arterial anatomy in an 11-year-old girl with a known horseshoe kidney', 'hash': 'e13c201ce16c8a2255a620612000584bd90231554133cd0aa57bf92b23e16b89'}, {'image_id': '467_2010_1645_Fig6_HTML', 'image_file_name': '467_2010_1645_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig6_HTML.jpg', 'caption': 'Computed tomography: a 15-year-old girl with chronic renal failure on peritoneal dialysis with recent onset of abdominal pain and signs of sepsis. The shriveled right kidney (arrow) is the expected size of both kidneys, but the left kidney shows acute pyelonephritis and is therefore enlarged, dilated, pus-filled, and has ruptured into the retroperitoneum', 'hash': 'b004b858b891e9e51b90c2a2dbe5716510259de4d46a5215cff69fc29f0b870f'}, {'image_id': '467_2010_1645_Fig1_HTML', 'image_file_name': '467_2010_1645_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig1_HTML.jpg', 'caption': 'Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneys', 'hash': '2bda13ee71cc7ccb3768a920eca865ccc0606c8414a8fc5ff13acc9bb7b5ebbb'}, {'image_id': '467_2010_1645_Fig2_HTML', 'image_file_name': '467_2010_1645_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig2_HTML.jpg', 'caption': 'Magnetic resonance imaging: an unexpected right-sided duplex kidney in a 7-month-old girl whose anatomy could not be delineated by ultrasound, with a tiny lower moiety that is almost hidden by the dilated upper moiety (arrow)', 'hash': '403293da21eb67c715412e7ff572bcfa0872f26136ff446f9384f449d8c905d7'}, {'image_id': '467_2010_1645_Fig5_HTML', 'image_file_name': '467_2010_1645_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig5_HTML.jpg', 'caption': 'Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study', 'hash': '3f9d938c3cf5a512836186aaa1ee070e78f1b13bab13cb5a74cc256ce2a52084'}, {'image_id': '467_2010_1645_Fig3_HTML', 'image_file_name': '467_2010_1645_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig3_HTML.jpg', 'caption': 'Magnetic resonance imaging: a 9-year-old boy with right-sided flank pain with a reconstructed postcontrast image showing an inferior pole “crossing” vessel (artery) (arrow) causing right-sided hydronephrosis', 'hash': 'f38d02c37d37c7111879d791ffb7e9da40e71a80f6cce9b347b253d6192527bd'}, {'image_id': '467_2010_1645_Fig4_HTML', 'image_file_name': '467_2010_1645_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig4_HTML.jpg', 'caption': 'Magnetic resonance imaging: T2-weighted sequence demonstrating the extent of bilateral pelviureteric junction obstruction, nondilation of ureters, and normal bladder, confirming the obstruction to be at the renal pelvis on both sides', 'hash': 'd7849cfac1f0565f0c6d0a1b21e9b2b3169e6211d9a7498efa826f781d73aa83'}] | {'467_2010_1645_Fig1_HTML': ['In pediatric practice, many congenital conditions of the urinary tract are demonstrated in utero on antenatal scans, whereas some are only detected in infancy or later due to subsequent complications. Ninety percent of fetal kidneys can be identified by 17–20\xa0weeks of gestation and 95% by 22\xa0weeks. Both antenatally and postnatally, US remains the examination of choice in demonstrating kidney and urinary tract anatomy. Structural urinary tract anomalies include renal dysplasia, renal hypoplasia, renal aplasia, multicystic dysplastic kidney, pelviureteric junction obstruction, duplication anomalies, fusion anomalies, renal ectopia, ureteroceles, cystic kidney diseases, and posterior urethral valves. All of these may be demonstrated by US, with additional information being acquired in some cases by other modalities (such as nuclear medicine imaging or fluoroscopy). MRI may subsequently be useful in these patients, as illustrated in Fig.\xa0<xref rid="467_2010_1645_Fig1_HTML" ref-type="fig">1</xref> for cystic disease, either in the further workup following US [ for cystic disease, either in the further workup following US [7, 9] when the clinical question has not been resolved, or when the child presents with (or has) complications that remain unexplained by US or require further delineation [10–12]. Heavily T2-weighted sequences (water-based sequences) are very useful in demonstrating dilatation of the urinary tract secondary to congenital anomalies, such as duplex kidneys with dilated moieties and occult moieties in a previously undiagnosed duplex kidney [13] (Fig.\xa0<xref rid="467_2010_1645_Fig2_HTML" ref-type="fig">2</xref>), and for demonstrating the exact anatomy of fusion anomalies, such as a crossed, fused, ectopic kidney and horseshoe kidney [), and for demonstrating the exact anatomy of fusion anomalies, such as a crossed, fused, ectopic kidney and horseshoe kidney [4, 6].\nFig.\xa01Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneysFig.\xa02Magnetic resonance imaging: an unexpected right-sided duplex kidney in a 7-month-old girl whose anatomy could not be delineated by ultrasound, with a tiny lower moiety that is almost hidden by the dilated upper moiety (arrow)'], '467_2010_1645_Fig3_HTML': ['CT arteriography (CTA) is sometimes performed in instances of known horseshoe kidney when surgery is being planned. This is to optimally delineate the multiple vessels that often supply these kidneys before surgery is undertaken. Pelviureteric junction obstruction can usually be diagnosed adequately on US, but a crossing vessel may be demonstrated by MRI (Fig.\xa0<xref rid="467_2010_1645_Fig3_HTML" ref-type="fig">3</xref>) [) [14], which cannot be visualized by US; in very gross hydronephrosis, MRI may give a better demonstration of the anatomy (Fig.\xa0<xref rid="467_2010_1645_Fig4_HTML" ref-type="fig">4</xref>).\n).\nFig.\xa03Magnetic resonance imaging: a 9-year-old boy with right-sided flank pain with a reconstructed postcontrast image showing an inferior pole “crossing” vessel (artery) (arrow) causing right-sided hydronephrosisFig.\xa04Magnetic resonance imaging: T2-weighted sequence demonstrating the extent of bilateral pelviureteric junction obstruction, nondilation of ureters, and normal bladder, confirming the obstruction to be at the renal pelvis on both sides'], '467_2010_1645_Fig5_HTML': ['Very complex urogenital anomalies, such as cloacal anomalies in female patients, are usually imaged by US and fluoroscopy in the first instance, but further cross-sectional imaging is invariably required. MRI may offer satisfactory depiction of the anatomy, but frequently, the workup has to occur very soon after birth so that an intermediate management plan can be made before definite surgery can be performed when the infant is older. In this situation, MRI is rarely able to offer sufficient spatial resolution to allow full understanding of the anatomy in these very small patients. In a few very select cases, CT, with a combined distal loopogram and micturating cystogram performed at the time of the scan, as well as contrast intravenously with the scan delayed to excretory phase, can offer exceptional 3D visualization of the entire urogenital tract (Fig.\xa0<xref rid="467_2010_1645_Fig5_HTML" ref-type="fig">5</xref>). There is little value in a conventional CT alone in these cases, and the routine use of CT is absolutely not advocated.\n). There is little value in a conventional CT alone in these cases, and the routine use of CT is absolutely not advocated.\nFig.\xa05Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study'], '467_2010_1645_Fig6_HTML': ['Most commonly, infection of the lower urinary tract presents clinically and is treated empirically. However, in a few more complicated cases, US will be performed to look for complications, such as abscess formation or pyelonephritis, within the kidneys and for the presence of underlying contributory factors, such as stone disease or previously undiagnosed structural anomalies. In most instances, US is able to resolve these clinical issues and is clearly the modality of choice for assessing infection (both in the acute stage and at follow-up). If US cannot answer the diagnostic question, further cross-sectional imaging may sometimes be useful. In the acute setting, with a very ill patient and suspected sepsis related to the urinary tract, CT may add further information regarding, for example, abscess rupture or retroperitoneal fluid (or pus) collections (Fig.\xa0<xref rid="467_2010_1645_Fig6_HTML" ref-type="fig">6</xref>). CT is useful in showing calcification and extrarenal complications in xanthogranulomatous pyelonephritis, if this has not already been confirmed by US. MRI may be of value after the acute episode for demonstrating underlying structural anomalies if these have not been determined by US.\n). CT is useful in showing calcification and extrarenal complications in xanthogranulomatous pyelonephritis, if this has not already been confirmed by US. MRI may be of value after the acute episode for demonstrating underlying structural anomalies if these have not been determined by US.\nFig.\xa06Computed tomography: a 15-year-old girl with chronic renal failure on peritoneal dialysis with recent onset of abdominal pain and signs of sepsis. The shriveled right kidney (arrow) is the expected size of both kidneys, but the left kidney shows acute pyelonephritis and is therefore enlarged, dilated, pus-filled, and has ruptured into the retroperitoneum'], '467_2010_1645_Fig7_HTML': ['Both CT and MRI can give excellent information with respect to normal vascular supply to the kidneys and wider urinary tract and in the context of vasculopathies. US would be the first-line investigation, but if anatomical delineation is required – for example, for surgical planning – then CT or MRI can be performed at the surgeon’s and radiologist’s discretion. CT will give better spatial resolution with the CT scan being performed in the arterial phase and allows 3D reconstruction of the vascular tree but at a considerable radiation dose. The clinician must be sure that sufficient information cannot be obtained by another method before proceeding. MRI is increasingly able to offer detailed vascular information with no radiation dose, and this should be considered as an entirely viable alternative in cooperative children (Fig.\xa0<xref rid="467_2010_1645_Fig7_HTML" ref-type="fig">7</xref>). At the time of writing this article, conventional angiography remained the gold standard for demonstrating subtle abnormalities in the renal vasculature, but it is both invasive and carries a relatively high radiation dose. However, in the diagnosis of subtle renal artery stenosis, for small arteriovenous malformations of the kidney, and for tiny aneurysms such as in polyarteritis nodosa or Wegner’s granulomatosis, it is still the investigation of choice. It is no longer indicated in the diagnosis or workup of renal tumors prior to surgery.\n). At the time of writing this article, conventional angiography remained the gold standard for demonstrating subtle abnormalities in the renal vasculature, but it is both invasive and carries a relatively high radiation dose. However, in the diagnosis of subtle renal artery stenosis, for small arteriovenous malformations of the kidney, and for tiny aneurysms such as in polyarteritis nodosa or Wegner’s granulomatosis, it is still the investigation of choice. It is no longer indicated in the diagnosis or workup of renal tumors prior to surgery.\nFig.\xa07Magnetic resonance imaging: gadolinium-enhanced MR angiography demonstrating arterial anatomy in an 11-year-old girl with a known horseshoe kidney'], '467_2010_1645_Fig8_HTML': ['Many tumors may involve the urinary tract depending on the organ of origin and the age of the child. Renal malignancies represent about 6% of cancer diagnoses in children <15\xa0years of age. Wilms tumor is by far the most common of the renal tumors, representing approximately 95% of cases overall and 96% in children <5\xa0years (Fig.\xa0<xref rid="467_2010_1645_Fig8_HTML" ref-type="fig">8</xref>).\n).\nFig.\xa08Computed tomography showing the extent of a large, left-sided Wilms tumor in a 2-year-old girl with thrombus extending the full length of the inferior vena cava (IVC) and into the right atrium (between arrows)', 'In all instances, the first imaging should be by US, which can confirm the presence of the mass and can usually (but not always) determine the organ of origin. However, further cross-sectional imaging is indicated for further anatomical delineation, information on tissues characteristics, and to establish staging. In centers with pediatric MRI, this is absolutely the imaging modality of choice: it provides a wealth of information regarding the tumor itself, provides a base-line for follow-up (thus avoiding repeated CTs), and can provide accurate staging. Sequences will typically include T1- and T2-weighted sequences, short-tau inversion recovery (STIR) sequences, apparent diffusion coefficient (ADC) sequences, and postgadolinium contrast-enhanced 3D fast low-angle shot (FLASH) sequences in a combination of axial and coronal planes. ADC sequences are relatively new in abdominal imaging (but have been used extensively in the brain for some time). These sequences give information about how easily water can diffuse in and between cells; thus, a tumor with densely packed cells will return low signal intensity and will appear dark on this MRI sequence. If it, or a part of it, is undergoing necrosis, it will return a higher (whiter) signal intensity. This is especially useful when monitoring a tumor to assess its response to treatment such as chemotherapy and to follow-up for recurrence. MRI can give information as to IVC and renal vein patency (Fig.\xa0<xref rid="467_2010_1645_Fig8_HTML" ref-type="fig">8</xref>) if this has not already been determined with certainty by US. Detailed MRA may also be performed, if necessary, to allow surgical planning. In centers with no access to MRI, then CT still provides good information, recognizing that it cannot supply tissue-specific information as MRI and that it incurs a heavy radiation burden. Follow-up of treated tumors should be by US where possible, although many cancer protocols determine that MRI (or CT) should be performed at specifically determined intervals.) if this has not already been determined with certainty by US. Detailed MRA may also be performed, if necessary, to allow surgical planning. In centers with no access to MRI, then CT still provides good information, recognizing that it cannot supply tissue-specific information as MRI and that it incurs a heavy radiation burden. Follow-up of treated tumors should be by US where possible, although many cancer protocols determine that MRI (or CT) should be performed at specifically determined intervals.']} | Imaging of the urinary tract: the role of CT and MRI | [
"Magnetic resonance imaging",
"Computed tomography",
"Ultrasonography",
"Child",
"Kidney",
"Urinary tract",
"Diagnostic imaging"
] | Pediatr Nephrol | 1294300800 | Computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly valuable tools for assessing the urinary tract in adults and children. However, their imaging capabilities, while overlapping in some respects, should be considered as complementary, as each technique offers specific advantages and disadvantages both in actual inherent qualities of the technique and in specific patients and with a specific diagnostic question. The use of CT and MRI should therefore be tailored to the patient and the clinical question. For the scope of this article, the advantages and disadvantages of these techniques in children will be considered; different considerations will apply in adult practice. | [
"Adult",
"Child",
"Humans",
"Magnetic Resonance Imaging",
"Tomography, X-Ray Computed",
"Ultrasonography",
"Urinary Tract",
"Urography",
"Urologic Diseases"
] | other | PMC2991216 | null | 26 | [
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"{'Citation': 'Calder AD, Hiorns MP, Abhyankar A, Mushtaq I, Olsen OE. Contrast-enhanced magnetic resonance angiography for the detection of crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with operative findings. Pediatr Radiol. 2007;37:356–361. doi: 10.1007/s00247-007-0416-2.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-007-0416-2'}, {'@IdType': 'pubmed', '#text': '17279400'}]}}",
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"{'Citation': 'Kalra MK, Maher MM, D’Souza RV, Rizzo S, Halpern EF, Blake MA, Saini S. Detection of urinary tract stones at low-radiation-dose CT with z-axis automatic tube current modulation: phantom and clinical studies. Radiology. 2005;235:523–529. doi: 10.1148/radiol.2352040331.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1148/radiol.2352040331'}, {'@IdType': 'pubmed', '#text': '15770037'}]}}",
"{'Citation': 'Memarsadeghi M, Heinz-Peer G, Helbich TH, Schaefer-Prokop C, Kramer G, Scharitzer M, Prokop M. Unenhanced multi-detector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis. Radiology. 2005;235:530–536. doi: 10.1148/radiol.2352040448.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1148/radiol.2352040448'}, {'@IdType': 'pubmed', '#text': '15758192'}]}}",
"{'Citation': 'Kirsch AJ, Grattan-Smith JD, Molitierno JA., Jr The role of magnetic resonance imaging in pediatric urology. Curr Opin Urol. 2006;16:283–290. doi: 10.1097/01.mou.0000232051.66718.34.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1097/01.mou.0000232051.66718.34'}, {'@IdType': 'pubmed', '#text': '16770129'}]}}",
"{'Citation': 'Rohrschneider WK, Haufe S, Clorius JH, Troger J. MR to assess renal function in children. Eur Radiol. 2003;13:1033–1045. doi: 10.1007/s00330-003-2005-6.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00330-003-2005-6'}, {'@IdType': 'pubmed', '#text': '12695825'}]}}",
"{'Citation': 'Jones RA, Schmotzer B, Little SB, Grattan-Smith JD. MRU post-processing. Pediatr Radiol. 2008;38(Suppl 1):S18–S27. doi: 10.1007/s00247-007-0616-9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-007-0616-9'}, {'@IdType': 'pubmed', '#text': '18071692'}]}}",
"{'Citation': 'Martin DR, Sharma P, Salman K, Jones RA, Grattan-Smith JD, Mao H, Lauenstein TC, Burrow BK, Tudorascu DL, Votaw JR. Individual kidney blood flow measured with contrast-enhanced first-pass perfusion MR imaging. Radiology. 2008;246:241–248.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18096538'}}}",
"{'Citation': 'Chandarana H, Lee VS. Renal functional MRI: Are we ready for clinical application? AJR Am J Roentgenol. 2009;192:1550–1557. doi: 10.2214/AJR.09.2390.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.2214/AJR.09.2390'}, {'@IdType': 'pubmed', '#text': '19457818'}]}}",
"{'Citation': 'Hofmann L, Simon-Zoula S, Nowak A, Giger A, Vock P, Boesch C, Frey FJ, Vogt B. BOLD-MRI for the assessment of renal oxygenation in humans: acute effect of nephrotoxic xenobiotics. Kidney Int. 2006;70:144–150. doi: 10.1038/sj.ki.5000418.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1038/sj.ki.5000418'}, {'@IdType': 'pubmed', '#text': '16641929'}]}}"
] | Pediatr Nephrol. 2011 Jan 6; 26(1):59-68 | NO-CC CODE |
|
Magnetic resonance imaging: T2-weighted sequence demonstrating the extent of bilateral pelviureteric junction obstruction, nondilation of ureters, and normal bladder, confirming the obstruction to be at the renal pelvis on both sides | 467_2010_1645_Fig4_HTML | 7 | d7849cfac1f0565f0c6d0a1b21e9b2b3169e6211d9a7498efa826f781d73aa83 | 467_2010_1645_Fig4_HTML.jpg | multiple | multiple panels: images | [
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"computerized tomography"
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496,
459
] | [{'image_id': '467_2010_1645_Fig8_HTML', 'image_file_name': '467_2010_1645_Fig8_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig8_HTML.jpg', 'caption': 'Computed tomography showing the extent of a large, left-sided Wilms tumor in a 2-year-old girl with thrombus extending the full length of the inferior vena cava (IVC) and into the right atrium (between arrows)', 'hash': '0d6e2381f7a461ed148ea31bf244e7b3f29c118bc1fbfcef35f2edd25a8dd02b'}, {'image_id': '467_2010_1645_Fig7_HTML', 'image_file_name': '467_2010_1645_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig7_HTML.jpg', 'caption': 'Magnetic resonance imaging: gadolinium-enhanced MR angiography demonstrating arterial anatomy in an 11-year-old girl with a known horseshoe kidney', 'hash': 'e13c201ce16c8a2255a620612000584bd90231554133cd0aa57bf92b23e16b89'}, {'image_id': '467_2010_1645_Fig6_HTML', 'image_file_name': '467_2010_1645_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig6_HTML.jpg', 'caption': 'Computed tomography: a 15-year-old girl with chronic renal failure on peritoneal dialysis with recent onset of abdominal pain and signs of sepsis. The shriveled right kidney (arrow) is the expected size of both kidneys, but the left kidney shows acute pyelonephritis and is therefore enlarged, dilated, pus-filled, and has ruptured into the retroperitoneum', 'hash': 'b004b858b891e9e51b90c2a2dbe5716510259de4d46a5215cff69fc29f0b870f'}, {'image_id': '467_2010_1645_Fig1_HTML', 'image_file_name': '467_2010_1645_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig1_HTML.jpg', 'caption': 'Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneys', 'hash': '2bda13ee71cc7ccb3768a920eca865ccc0606c8414a8fc5ff13acc9bb7b5ebbb'}, {'image_id': '467_2010_1645_Fig2_HTML', 'image_file_name': '467_2010_1645_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig2_HTML.jpg', 'caption': 'Magnetic resonance imaging: an unexpected right-sided duplex kidney in a 7-month-old girl whose anatomy could not be delineated by ultrasound, with a tiny lower moiety that is almost hidden by the dilated upper moiety (arrow)', 'hash': '403293da21eb67c715412e7ff572bcfa0872f26136ff446f9384f449d8c905d7'}, {'image_id': '467_2010_1645_Fig5_HTML', 'image_file_name': '467_2010_1645_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig5_HTML.jpg', 'caption': 'Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study', 'hash': '3f9d938c3cf5a512836186aaa1ee070e78f1b13bab13cb5a74cc256ce2a52084'}, {'image_id': '467_2010_1645_Fig3_HTML', 'image_file_name': '467_2010_1645_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig3_HTML.jpg', 'caption': 'Magnetic resonance imaging: a 9-year-old boy with right-sided flank pain with a reconstructed postcontrast image showing an inferior pole “crossing” vessel (artery) (arrow) causing right-sided hydronephrosis', 'hash': 'f38d02c37d37c7111879d791ffb7e9da40e71a80f6cce9b347b253d6192527bd'}, {'image_id': '467_2010_1645_Fig4_HTML', 'image_file_name': '467_2010_1645_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC2991216/467_2010_1645_Fig4_HTML.jpg', 'caption': 'Magnetic resonance imaging: T2-weighted sequence demonstrating the extent of bilateral pelviureteric junction obstruction, nondilation of ureters, and normal bladder, confirming the obstruction to be at the renal pelvis on both sides', 'hash': 'd7849cfac1f0565f0c6d0a1b21e9b2b3169e6211d9a7498efa826f781d73aa83'}] | {'467_2010_1645_Fig1_HTML': ['In pediatric practice, many congenital conditions of the urinary tract are demonstrated in utero on antenatal scans, whereas some are only detected in infancy or later due to subsequent complications. Ninety percent of fetal kidneys can be identified by 17–20\xa0weeks of gestation and 95% by 22\xa0weeks. Both antenatally and postnatally, US remains the examination of choice in demonstrating kidney and urinary tract anatomy. Structural urinary tract anomalies include renal dysplasia, renal hypoplasia, renal aplasia, multicystic dysplastic kidney, pelviureteric junction obstruction, duplication anomalies, fusion anomalies, renal ectopia, ureteroceles, cystic kidney diseases, and posterior urethral valves. All of these may be demonstrated by US, with additional information being acquired in some cases by other modalities (such as nuclear medicine imaging or fluoroscopy). MRI may subsequently be useful in these patients, as illustrated in Fig.\xa0<xref rid="467_2010_1645_Fig1_HTML" ref-type="fig">1</xref> for cystic disease, either in the further workup following US [ for cystic disease, either in the further workup following US [7, 9] when the clinical question has not been resolved, or when the child presents with (or has) complications that remain unexplained by US or require further delineation [10–12]. Heavily T2-weighted sequences (water-based sequences) are very useful in demonstrating dilatation of the urinary tract secondary to congenital anomalies, such as duplex kidneys with dilated moieties and occult moieties in a previously undiagnosed duplex kidney [13] (Fig.\xa0<xref rid="467_2010_1645_Fig2_HTML" ref-type="fig">2</xref>), and for demonstrating the exact anatomy of fusion anomalies, such as a crossed, fused, ectopic kidney and horseshoe kidney [), and for demonstrating the exact anatomy of fusion anomalies, such as a crossed, fused, ectopic kidney and horseshoe kidney [4, 6].\nFig.\xa01Magnetic resonance image: coronal T2 sequence in a 6-month-old girl with autosomal dominant polycystic kidney disease showing multiples high-signal cysts throughout both kidneysFig.\xa02Magnetic resonance imaging: an unexpected right-sided duplex kidney in a 7-month-old girl whose anatomy could not be delineated by ultrasound, with a tiny lower moiety that is almost hidden by the dilated upper moiety (arrow)'], '467_2010_1645_Fig3_HTML': ['CT arteriography (CTA) is sometimes performed in instances of known horseshoe kidney when surgery is being planned. This is to optimally delineate the multiple vessels that often supply these kidneys before surgery is undertaken. Pelviureteric junction obstruction can usually be diagnosed adequately on US, but a crossing vessel may be demonstrated by MRI (Fig.\xa0<xref rid="467_2010_1645_Fig3_HTML" ref-type="fig">3</xref>) [) [14], which cannot be visualized by US; in very gross hydronephrosis, MRI may give a better demonstration of the anatomy (Fig.\xa0<xref rid="467_2010_1645_Fig4_HTML" ref-type="fig">4</xref>).\n).\nFig.\xa03Magnetic resonance imaging: a 9-year-old boy with right-sided flank pain with a reconstructed postcontrast image showing an inferior pole “crossing” vessel (artery) (arrow) causing right-sided hydronephrosisFig.\xa04Magnetic resonance imaging: T2-weighted sequence demonstrating the extent of bilateral pelviureteric junction obstruction, nondilation of ureters, and normal bladder, confirming the obstruction to be at the renal pelvis on both sides'], '467_2010_1645_Fig5_HTML': ['Very complex urogenital anomalies, such as cloacal anomalies in female patients, are usually imaged by US and fluoroscopy in the first instance, but further cross-sectional imaging is invariably required. MRI may offer satisfactory depiction of the anatomy, but frequently, the workup has to occur very soon after birth so that an intermediate management plan can be made before definite surgery can be performed when the infant is older. In this situation, MRI is rarely able to offer sufficient spatial resolution to allow full understanding of the anatomy in these very small patients. In a few very select cases, CT, with a combined distal loopogram and micturating cystogram performed at the time of the scan, as well as contrast intravenously with the scan delayed to excretory phase, can offer exceptional 3D visualization of the entire urogenital tract (Fig.\xa0<xref rid="467_2010_1645_Fig5_HTML" ref-type="fig">5</xref>). There is little value in a conventional CT alone in these cases, and the routine use of CT is absolutely not advocated.\n). There is little value in a conventional CT alone in these cases, and the routine use of CT is absolutely not advocated.\nFig.\xa05Computed tomography: Reconstructed 3D images showing the complicated anatomy of the urogenital tract in a 3-month-old girl with a cloacal anomaly; the entire urogenital system is demonstrated in one study'], '467_2010_1645_Fig6_HTML': ['Most commonly, infection of the lower urinary tract presents clinically and is treated empirically. However, in a few more complicated cases, US will be performed to look for complications, such as abscess formation or pyelonephritis, within the kidneys and for the presence of underlying contributory factors, such as stone disease or previously undiagnosed structural anomalies. In most instances, US is able to resolve these clinical issues and is clearly the modality of choice for assessing infection (both in the acute stage and at follow-up). If US cannot answer the diagnostic question, further cross-sectional imaging may sometimes be useful. In the acute setting, with a very ill patient and suspected sepsis related to the urinary tract, CT may add further information regarding, for example, abscess rupture or retroperitoneal fluid (or pus) collections (Fig.\xa0<xref rid="467_2010_1645_Fig6_HTML" ref-type="fig">6</xref>). CT is useful in showing calcification and extrarenal complications in xanthogranulomatous pyelonephritis, if this has not already been confirmed by US. MRI may be of value after the acute episode for demonstrating underlying structural anomalies if these have not been determined by US.\n). CT is useful in showing calcification and extrarenal complications in xanthogranulomatous pyelonephritis, if this has not already been confirmed by US. MRI may be of value after the acute episode for demonstrating underlying structural anomalies if these have not been determined by US.\nFig.\xa06Computed tomography: a 15-year-old girl with chronic renal failure on peritoneal dialysis with recent onset of abdominal pain and signs of sepsis. The shriveled right kidney (arrow) is the expected size of both kidneys, but the left kidney shows acute pyelonephritis and is therefore enlarged, dilated, pus-filled, and has ruptured into the retroperitoneum'], '467_2010_1645_Fig7_HTML': ['Both CT and MRI can give excellent information with respect to normal vascular supply to the kidneys and wider urinary tract and in the context of vasculopathies. US would be the first-line investigation, but if anatomical delineation is required – for example, for surgical planning – then CT or MRI can be performed at the surgeon’s and radiologist’s discretion. CT will give better spatial resolution with the CT scan being performed in the arterial phase and allows 3D reconstruction of the vascular tree but at a considerable radiation dose. The clinician must be sure that sufficient information cannot be obtained by another method before proceeding. MRI is increasingly able to offer detailed vascular information with no radiation dose, and this should be considered as an entirely viable alternative in cooperative children (Fig.\xa0<xref rid="467_2010_1645_Fig7_HTML" ref-type="fig">7</xref>). At the time of writing this article, conventional angiography remained the gold standard for demonstrating subtle abnormalities in the renal vasculature, but it is both invasive and carries a relatively high radiation dose. However, in the diagnosis of subtle renal artery stenosis, for small arteriovenous malformations of the kidney, and for tiny aneurysms such as in polyarteritis nodosa or Wegner’s granulomatosis, it is still the investigation of choice. It is no longer indicated in the diagnosis or workup of renal tumors prior to surgery.\n). At the time of writing this article, conventional angiography remained the gold standard for demonstrating subtle abnormalities in the renal vasculature, but it is both invasive and carries a relatively high radiation dose. However, in the diagnosis of subtle renal artery stenosis, for small arteriovenous malformations of the kidney, and for tiny aneurysms such as in polyarteritis nodosa or Wegner’s granulomatosis, it is still the investigation of choice. It is no longer indicated in the diagnosis or workup of renal tumors prior to surgery.\nFig.\xa07Magnetic resonance imaging: gadolinium-enhanced MR angiography demonstrating arterial anatomy in an 11-year-old girl with a known horseshoe kidney'], '467_2010_1645_Fig8_HTML': ['Many tumors may involve the urinary tract depending on the organ of origin and the age of the child. Renal malignancies represent about 6% of cancer diagnoses in children <15\xa0years of age. Wilms tumor is by far the most common of the renal tumors, representing approximately 95% of cases overall and 96% in children <5\xa0years (Fig.\xa0<xref rid="467_2010_1645_Fig8_HTML" ref-type="fig">8</xref>).\n).\nFig.\xa08Computed tomography showing the extent of a large, left-sided Wilms tumor in a 2-year-old girl with thrombus extending the full length of the inferior vena cava (IVC) and into the right atrium (between arrows)', 'In all instances, the first imaging should be by US, which can confirm the presence of the mass and can usually (but not always) determine the organ of origin. However, further cross-sectional imaging is indicated for further anatomical delineation, information on tissues characteristics, and to establish staging. In centers with pediatric MRI, this is absolutely the imaging modality of choice: it provides a wealth of information regarding the tumor itself, provides a base-line for follow-up (thus avoiding repeated CTs), and can provide accurate staging. Sequences will typically include T1- and T2-weighted sequences, short-tau inversion recovery (STIR) sequences, apparent diffusion coefficient (ADC) sequences, and postgadolinium contrast-enhanced 3D fast low-angle shot (FLASH) sequences in a combination of axial and coronal planes. ADC sequences are relatively new in abdominal imaging (but have been used extensively in the brain for some time). These sequences give information about how easily water can diffuse in and between cells; thus, a tumor with densely packed cells will return low signal intensity and will appear dark on this MRI sequence. If it, or a part of it, is undergoing necrosis, it will return a higher (whiter) signal intensity. This is especially useful when monitoring a tumor to assess its response to treatment such as chemotherapy and to follow-up for recurrence. MRI can give information as to IVC and renal vein patency (Fig.\xa0<xref rid="467_2010_1645_Fig8_HTML" ref-type="fig">8</xref>) if this has not already been determined with certainty by US. Detailed MRA may also be performed, if necessary, to allow surgical planning. In centers with no access to MRI, then CT still provides good information, recognizing that it cannot supply tissue-specific information as MRI and that it incurs a heavy radiation burden. Follow-up of treated tumors should be by US where possible, although many cancer protocols determine that MRI (or CT) should be performed at specifically determined intervals.) if this has not already been determined with certainty by US. Detailed MRA may also be performed, if necessary, to allow surgical planning. In centers with no access to MRI, then CT still provides good information, recognizing that it cannot supply tissue-specific information as MRI and that it incurs a heavy radiation burden. Follow-up of treated tumors should be by US where possible, although many cancer protocols determine that MRI (or CT) should be performed at specifically determined intervals.']} | Imaging of the urinary tract: the role of CT and MRI | [
"Magnetic resonance imaging",
"Computed tomography",
"Ultrasonography",
"Child",
"Kidney",
"Urinary tract",
"Diagnostic imaging"
] | Pediatr Nephrol | 1294300800 | Computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly valuable tools for assessing the urinary tract in adults and children. However, their imaging capabilities, while overlapping in some respects, should be considered as complementary, as each technique offers specific advantages and disadvantages both in actual inherent qualities of the technique and in specific patients and with a specific diagnostic question. The use of CT and MRI should therefore be tailored to the patient and the clinical question. For the scope of this article, the advantages and disadvantages of these techniques in children will be considered; different considerations will apply in adult practice. | [
"Adult",
"Child",
"Humans",
"Magnetic Resonance Imaging",
"Tomography, X-Ray Computed",
"Ultrasonography",
"Urinary Tract",
"Urography",
"Urologic Diseases"
] | other | PMC2991216 | null | 26 | [
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"{'Citation': 'Grattan-Smith JD, Jones RA. Magnetic resonance urography in children. Magn Reson Imaging Clin N Am. 2008;16:515–531. doi: 10.1016/j.mric.2008.04.002.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/j.mric.2008.04.002'}, {'@IdType': 'pubmed', '#text': '18585602'}]}}",
"{'Citation': 'Grattan-Smith JD. MR urography: anatomy and physiology. Pediatr Radiol. 2008;38(Suppl 2):S275–S280. doi: 10.1007/s00247-008-0793-1.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-008-0793-1'}, {'@IdType': 'pubmed', '#text': '18401626'}]}}",
"{'Citation': 'Grattan-Smith JD, Jones RA. MR urography: technique and results for the evaluation of urinary obstruction in the pediatric population. Magn Reson Imaging Clin N Am. 2008;16:643–660. doi: 10.1016/j.mric.2008.07.003.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/j.mric.2008.07.003'}, {'@IdType': 'pubmed', '#text': '18926428'}]}}",
"{'Citation': 'Greenbaum LA. Renal dysplasia and MRI: a clinician’s perspective. Pediatr Radiol. 2008;38(Suppl 1):S70–S75. doi: 10.1007/s00247-007-0586-y.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-007-0586-y'}, {'@IdType': 'pubmed', '#text': '18071696'}]}}",
"{'Citation': 'Little SB, Jones RA, Grattan-Smith JD. Evaluation of UPJ obstruction before and after pyeloplasty using MR urography. Pediatr Radiol. 2008;38(Suppl 1):S106–S124. doi: 10.1007/s00247-007-0669-9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-007-0669-9'}, {'@IdType': 'pubmed', '#text': '18071687'}]}}",
"{'Citation': 'Cerwinka WH, Damien Grattan-Smith J, Kirsch AJ (2008) Magnetic resonance urography in pediatric urology. J Pediatr Urol 4:74–82, quiz 82-83', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18631897'}}}",
"{'Citation': 'Lipson JA, Coakley FV, Baskin LS, Yeh BM. Subtle renal duplication as an unrecognized cause of childhood incontinence: diagnosis by magnetic resonance urography. J Pediatr Urol. 2008;4:398–400. doi: 10.1016/j.jpurol.2008.01.213.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/j.jpurol.2008.01.213'}, {'@IdType': 'pmc', '#text': 'PMC2572184'}, {'@IdType': 'pubmed', '#text': '18790427'}]}}",
"{'Citation': 'Calder AD, Hiorns MP, Abhyankar A, Mushtaq I, Olsen OE. Contrast-enhanced magnetic resonance angiography for the detection of crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with operative findings. Pediatr Radiol. 2007;37:356–361. doi: 10.1007/s00247-007-0416-2.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-007-0416-2'}, {'@IdType': 'pubmed', '#text': '17279400'}]}}",
"{'Citation': 'Kawashima A, Sandler CM, Corl FM, West OC, Tamm EP, Fishman EK, Goldman SM. Imaging of renal trauma: a comprehensive review. Radiographics. 2001;21:557–574.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11353106'}}}",
"{'Citation': 'McAninch J. Renal injuries. In: Gillenwater J, Grayhack J, Howards S, Duckett J, editors. Adult and pediatric urologyMosby. Mo: St Louis; 1996. pp. 539–553.'}",
"{'Citation': 'Lee YJ, Oh SN, Rha SE, Byun JY. Renal trauma. Radiol Clin North Am. 2007;45:581–592. doi: 10.1016/j.rcl.2007.04.004.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/j.rcl.2007.04.004'}, {'@IdType': 'pubmed', '#text': '17601510'}]}}",
"{'Citation': 'Smith RC, Verga M, McCarthy S, Rosenfield AT. Diagnosis of acute flank pain: value of unenhanced helical CT. AJR Am J Roentgenol. 1996;166:97–101.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8571915'}}}",
"{'Citation': 'Kalra MK, Maher MM, D’Souza RV, Rizzo S, Halpern EF, Blake MA, Saini S. Detection of urinary tract stones at low-radiation-dose CT with z-axis automatic tube current modulation: phantom and clinical studies. Radiology. 2005;235:523–529. doi: 10.1148/radiol.2352040331.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1148/radiol.2352040331'}, {'@IdType': 'pubmed', '#text': '15770037'}]}}",
"{'Citation': 'Memarsadeghi M, Heinz-Peer G, Helbich TH, Schaefer-Prokop C, Kramer G, Scharitzer M, Prokop M. Unenhanced multi-detector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis. Radiology. 2005;235:530–536. doi: 10.1148/radiol.2352040448.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1148/radiol.2352040448'}, {'@IdType': 'pubmed', '#text': '15758192'}]}}",
"{'Citation': 'Kirsch AJ, Grattan-Smith JD, Molitierno JA., Jr The role of magnetic resonance imaging in pediatric urology. Curr Opin Urol. 2006;16:283–290. doi: 10.1097/01.mou.0000232051.66718.34.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1097/01.mou.0000232051.66718.34'}, {'@IdType': 'pubmed', '#text': '16770129'}]}}",
"{'Citation': 'Rohrschneider WK, Haufe S, Clorius JH, Troger J. MR to assess renal function in children. Eur Radiol. 2003;13:1033–1045. doi: 10.1007/s00330-003-2005-6.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00330-003-2005-6'}, {'@IdType': 'pubmed', '#text': '12695825'}]}}",
"{'Citation': 'Jones RA, Schmotzer B, Little SB, Grattan-Smith JD. MRU post-processing. Pediatr Radiol. 2008;38(Suppl 1):S18–S27. doi: 10.1007/s00247-007-0616-9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00247-007-0616-9'}, {'@IdType': 'pubmed', '#text': '18071692'}]}}",
"{'Citation': 'Martin DR, Sharma P, Salman K, Jones RA, Grattan-Smith JD, Mao H, Lauenstein TC, Burrow BK, Tudorascu DL, Votaw JR. Individual kidney blood flow measured with contrast-enhanced first-pass perfusion MR imaging. Radiology. 2008;246:241–248.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18096538'}}}",
"{'Citation': 'Chandarana H, Lee VS. Renal functional MRI: Are we ready for clinical application? AJR Am J Roentgenol. 2009;192:1550–1557. doi: 10.2214/AJR.09.2390.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.2214/AJR.09.2390'}, {'@IdType': 'pubmed', '#text': '19457818'}]}}",
"{'Citation': 'Hofmann L, Simon-Zoula S, Nowak A, Giger A, Vock P, Boesch C, Frey FJ, Vogt B. BOLD-MRI for the assessment of renal oxygenation in humans: acute effect of nephrotoxic xenobiotics. Kidney Int. 2006;70:144–150. doi: 10.1038/sj.ki.5000418.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1038/sj.ki.5000418'}, {'@IdType': 'pubmed', '#text': '16641929'}]}}"
] | Pediatr Nephrol. 2011 Jan 6; 26(1):59-68 | NO-CC CODE |
|
T2-weighted MRI showing high signal in the calcaneus. | 10.1177_1941738113486588-fig5 | 7 | d95d35371b6721a9a6f1b294a7cc5ac56c2452b21ba763efb4f84b58fe9fdee3 | 10.1177_1941738113486588-fig5.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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"computerized tomography"
] | [
576,
458
] | [{'image_id': '10.1177_1941738113486588-fig5', 'image_file_name': '10.1177_1941738113486588-fig5.jpg', 'image_path': '../data/media_files/PMC4212349/10.1177_1941738113486588-fig5.jpg', 'caption': 'T2-weighted MRI showing high signal in the calcaneus.', 'hash': 'd95d35371b6721a9a6f1b294a7cc5ac56c2452b21ba763efb4f84b58fe9fdee3'}, {'image_id': '10.1177_1941738113486588-fig2', 'image_file_name': '10.1177_1941738113486588-fig2.jpg', 'image_path': '../data/media_files/PMC4212349/10.1177_1941738113486588-fig2.jpg', 'caption': 'T2-weighted MRI showing high signal in the talus.', 'hash': '4a2a8b93e8841404641a1cafef7bc8c6375bb68f8a221db2ddbaae732435539c'}, {'image_id': '10.1177_1941738113486588-img1', 'image_file_name': '10.1177_1941738113486588-img1.jpg', 'image_path': '../data/media_files/PMC4212349/10.1177_1941738113486588-img1.jpg', 'caption': None, 'hash': '1ce8415cf0149ffe68c170601269b03b335824431e0dd62966ae7d86671ac9c1'}, {'image_id': '10.1177_1941738113486588-fig3', 'image_file_name': '10.1177_1941738113486588-fig3.jpg', 'image_path': '../data/media_files/PMC4212349/10.1177_1941738113486588-fig3.jpg', 'caption': 'T2-weighted MRI showing high signal in the navicular.', 'hash': '0d5b1dfc636d32aea60d105a6290e98ad4cc230b594112b79c6f644328c7ab79'}, {'image_id': '10.1177_1941738113486588-fig4', 'image_file_name': '10.1177_1941738113486588-fig4.jpg', 'image_path': '../data/media_files/PMC4212349/10.1177_1941738113486588-fig4.jpg', 'caption': 'T2-weighted MRI showing high signal in the distal fourth metatarsal.', 'hash': '10ab7c2410d8e27a8b303b8d05051487d0064e98547ff1860830ee660eaa13ed'}, {'image_id': '10.1177_1941738113486588-fig1', 'image_file_name': '10.1177_1941738113486588-fig1.jpg', 'image_path': '../data/media_files/PMC4212349/10.1177_1941738113486588-fig1.jpg', 'caption': 'T2-weighted MRI showing high signal in the medial malleolus.', 'hash': '300b63300d63c03b0f462ef8d2beb1bf37f360059e06ac41b2a9b833ea6c7f30'}] | {'10.1177_1941738113486588-fig1': ['A patient with concerning symptoms but negative radiographs should undergo a bone scan or MRI (<xref ref-type="fig" rid="10.1177_1941738113486588-fig1">Figure 1</xref>). An incomplete fracture on MRI or a positive bone scan can be treated with cast immobilization and nonweightbearing.). An incomplete fracture on MRI or a positive bone scan can be treated with cast immobilization and nonweightbearing.75,89,91 Although most of these injuries will heal with appropriate nonoperative treatments, internal fixation may be considered to allow earlier return to competitive sports, often within 1 to 2 months.52,75,89,91 Several series of medial malleolar stress fractures in athletes showed that both time to healing and return to sport were longer in the nonoperative group.89'], '10.1177_1941738113486588-fig2': ['Talar stress fractures were first described in 1965 by McGlone.60 It is a relatively rare injury; athletes and military recruits performing repetitive axial loading activities are most prone to this injury.82,93,94 Advanced imaging, particularly MRI, is often required to obtain a diagnosis (<xref ref-type="fig" rid="10.1177_1941738113486588-fig2">Figure 2</xref>).).14,93,94 Physical examination findings are variable, including point tenderness, ankle effusion, or soft tissue swelling.14,60,93,94 Excessive subtalar pronation or plantar flexion is noted clinically in many patients with lateral process stress injuries due to impingement of the lateral process of the calcaneus on the posterolateral talus.14 The superior part of the talar head is most frequently involved, and the posterolateral talar body fracture will usually be seen extending into the subtalar joint.14,93'], '10.1177_1941738113486588-fig3': ['Navicular stress fractures are currently considered high risk due to the rate of nonunion.12,35 Patients are usually involved in explosive sprinting or jumping activities and complain of pain at the dorsum of the midfoot or along the medial longitudinal arch with activity.99 Swelling, erythema, and ecchymosis are less reliable, but point tenderness at the dorsal aspect of the navicular known as N-spot tenderness is the most consistent finding.12,35 Clinical suspicion should prompt radiographic evaluation, and advanced imaging should be obtained if initial radiographs are negative.33,99 MRI (<xref ref-type="fig" rid="10.1177_1941738113486588-fig3">Figure 3</xref>) and bone scan provide no additional benefit over CT.) and bone scan provide no additional benefit over CT.19,31 The fracture line usually extends from the proximal dorsal border in a plantar and distal direction in the sagittal plane.19,33 The central third of the navicular is a watershed area between blood supplies coming from medial and lateral vessels.99 This may lead to slower healing of physiologic microfractures in this central area and increase the risk of a stress fracture.99 During walking and running, this region is also subjected to shear forces from the first and second metatarsals (through the cuneiforms) along the convex surface distally and the talus at the concave surface proximally.33,35 Anatomical risk factors include a relatively long second metatarsal, pes cavus, metatarsus adductus, medial narrowing of the talonavicular joint, talar beaking, and limited subtalar or ankle motion.44'], '10.1177_1941738113486588-fig4': ['These stress fractures occur most frequently in the second and third metatarsals and are relatively common.12,13,35,46 They are considered high or low risk, depending on location.12,13,35,46 Common in runners, military recruits, ballet dancers, and basketball players, like most, patients will report a recent increase in training.1,8,12,13,16,17,21-23,29,31,32,35,38,39,46,48,55,58,62,64,67,74,77,79,85,90,97,102,104 Forefoot pain with weightbearing, inability to toe walk, point tenderness, and swelling are present on examination.1,8,12,13,16,17,21-23,29,31,32,35,38,39,46,48,55,58,62,64,67,74,77,79,85,90,97,102,104 Radiographic work-up with plain films of the foot may show callus formation about the metatarsal at around 2 weeks.1,12,13,16,17,22,23,29,34,38,39,46,55,58,62,67,74,85 As with other stress fractures, increased uptake on bone scan should be isolated to the affected bone; MRI (<xref ref-type="fig" rid="10.1177_1941738113486588-fig4">Figure 4</xref>) can differentiate between stress reaction or fracture and soft tissue abnormalities.) can differentiate between stress reaction or fracture and soft tissue abnormalities.35,46,85'], '10.1177_1941738113486588-fig5': ['The incidence of calcaneal stress fractures is highest in military recruits and long-distance runners.35,40,95,106 A positive calcaneal compression test with some amount of swelling is usually present.35,40,49,103 The diagnosis is often missed initially because of similarity to plantar fasciitis, Baxter nerve entrapment and insertional achilles tendonitis, atrophic heel pad and retrocalcaneal bursitis, and in adolescents, Sever disease or calcaneal apophysitis.35 Plain films will often show a sclerotic or radiolucent line after 2 to 3 weeks of symptoms, and a bone scan or MRI could be helpful to rule out soft tissue diagnoses (<xref ref-type="fig" rid="10.1177_1941738113486588-fig5">Figure 5</xref>).).35,95,106 Calcaneal stress fractures can be adequately treated with activity modification without casting or surgical intervention.40,49,103 In a more recent Finnish military study of 34 stress injuries (reactions and fractures), 65% were associated with talar, cuboid, or navicular stress injuries. Nonoperative management was used in all patients; recruits were asymptomatic at an average of 77 days. They concluded that these injuries can be treated nonoperatively with suspension from activity only.106']} | Stress Fractures of the Foot and Ankle in Athletes | [
"stress fracture",
"athlete",
"foot",
"ankle"
] | Sports Health | 1414825200 | None | null | other | PMC4212349 | null | null | [
""
] | Sports Health. 2014 Nov; 6(6):481-491 | NO-CC CODE |
|
Preoperative lumbar CT-scan (A) and MRI (B) showed the proximity of migrated rod to the foramen of the exit of the left S1 root and the intensive inflammatory reaction of the surrounding bone, each indicated by arrows. | cmo-6-2012-375f2 | 7 | fed0db115f033f998bf9a7eb61f6a6d6f5e5f813235a1c769ddfeb8804633e19 | cmo-6-2012-375f2.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
667,
257
] | [{'image_id': 'cmo-6-2012-375f1', 'image_file_name': 'cmo-6-2012-375f1.jpg', 'image_path': '../data/media_files/PMC3511055/cmo-6-2012-375f1.jpg', 'caption': 'A preoperative lumbosacral MRI showed a L3 involvement by lymphomatous tissue with evidence of intracanalar diffusion as indicated by arrow (A). A postoperative MRI with evidence of surgical procedure of decompressive laminectomy and stabilization with titanium pedicle screws (see arrow) and rods (B).', 'hash': '0cee413b04bd7421629548e468151e20fe416d4a1ffe165445bbe169b0399c91'}, {'image_id': 'cmo-6-2012-375f3', 'image_file_name': 'cmo-6-2012-375f3.jpg', 'image_path': '../data/media_files/PMC3511055/cmo-6-2012-375f3.jpg', 'caption': 'AP and LL lumbar x-ray performed after an S1 left radiculopathy onset showed the migration of both paravertebral rods, with the left one migrated in the pre-sacral region and the right one positioned at the upper level of second lumbar vertebral body (A and B). A coronal and sagittal plane of preoperative MRI allowed the visualization of the bone sacral groove created by the migrated left rod as marked by arrows (C and D).', 'hash': '1b9d3acce46a72d8950980e819d2fe1d24745bf6c81a209971898ed6f9b09ada'}, {'image_id': 'cmo-6-2012-375f4', 'image_file_name': 'cmo-6-2012-375f4.jpg', 'image_path': '../data/media_files/PMC3511055/cmo-6-2012-375f4.jpg', 'caption': 'Lumbar preoperative CT scan with evidence of bone formation around the migrated rods probably due to micro movements (A and B). The arrows show the strong bone reaction that during the second surgical procedure needed bone drilling to grant rods removal (C and D).', 'hash': '898177007cdbe8074be42a273b3cbe720d10bebda715463838ec6569a0e5a094'}, {'image_id': 'cmo-6-2012-375f5', 'image_file_name': 'cmo-6-2012-375f5.jpg', 'image_path': '../data/media_files/PMC3511055/cmo-6-2012-375f5.jpg', 'caption': 'Postoperative lumbar MRI (A) and LL X-ray (B) with evidence of screws and rods removal, and L3 vertebroplasty (see arrow) with preservation of spine stability.', 'hash': 'bb32da8022daeb8b628ec1968600ef41988532420407f4f0af6e28c391fcbbee'}, {'image_id': 'cmo-6-2012-375f2', 'image_file_name': 'cmo-6-2012-375f2.jpg', 'image_path': '../data/media_files/PMC3511055/cmo-6-2012-375f2.jpg', 'caption': 'Preoperative lumbar CT-scan (A) and MRI (B) showed the proximity of migrated rod to the foramen of the exit of the left S1 root and the intensive inflammatory reaction of the surrounding bone, each indicated by arrows.', 'hash': 'fed0db115f033f998bf9a7eb61f6a6d6f5e5f813235a1c769ddfeb8804633e19'}] | {'cmo-6-2012-375f1': ['A caucasic woman of 69 years with history of hypertension was admitted to the emergency room in 2005 for severe low back pain. There was neuroradiological (lumbar X-rays and CT scan) evidence of a pathological fracture of the third lumbar vertebral body with subsequent lumbar canal stenosis. Two days later, a surgical procedure of posterior lumbar stabilization with titanium pedicle screws (located at L2 and L4) and rods associated with a decompressive laminectomy was performed, in addition to a biopsy (<xref ref-type="fig" rid="cmo-6-2012-375f1">Fig. 1</xref>). After the histological diagnosis of a diffuse non-Hodgkin B-cell lymphoma (Stage IV A), tailored adjuvant chemotherapy (five cycles of cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (CHOP) protocol) and involved field radiotherapy (total dose 30 Gy) were planned.). After the histological diagnosis of a diffuse non-Hodgkin B-cell lymphoma (Stage IV A), tailored adjuvant chemotherapy (five cycles of cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (CHOP) protocol) and involved field radiotherapy (total dose 30 Gy) were planned.'], 'cmo-6-2012-375f2': ['In August 2011, because of the worsening of the S1 left radiculopathy and the appearance of a motor deficit in foot flexion, a lumbar X-ray and a new MRI finally showed an unusual migration of both rods. The left one was distally migrated to the pre-sacral region adjacent to the sacral foramen of the exit of the S1 root (<xref ref-type="fig" rid="cmo-6-2012-375f2">Fig. 2</xref>) and the right one was positioned on the upper level of the second lumbar vertebral body () and the right one was positioned on the upper level of the second lumbar vertebral body (<xref ref-type="fig" rid="cmo-6-2012-375f2">Figs. 2</xref> and and <xref ref-type="fig" rid="cmo-6-2012-375f3">3</xref>). A critical retrospective analysis of a previous MRI demonstrated that, in some slices, the migration had already been evident (). A critical retrospective analysis of a previous MRI demonstrated that, in some slices, the migration had already been evident (<xref ref-type="fig" rid="cmo-6-2012-375f3">Fig. 3</xref>).).'], 'cmo-6-2012-375f4': ['Afterwards, the patient was submitted to a second surgical procedure. This procedure involved removal of screws and rods with concomitant L3 vertebroplasty, without hardware replacement. There was no hardware replacement because of the posterolateral arthrodesis process was adequate and complete (<xref ref-type="fig" rid="cmo-6-2012-375f4">Figs. 4</xref> and and <xref ref-type="fig" rid="cmo-6-2012-375f5">5</xref>).).', 'A further unusual event of our case report is the evidence of opposite migration of both rods, probably due not only to the usual flexion and extension movements, but mainly to the lateral bending ones. Beside rods mobilization, a post-operative CT-scan showed a complete arthrodesis process around the rods, theoretically due to device micro movements that induced solid bone formation (<xref ref-type="fig" rid="cmo-6-2012-375f4">Fig. 4</xref>). This bone formation provided adequate arthrodesis and spine stability, but did not prevent the rods migration inside the bony tunnel. This condition justifies the clinical picture because the patient did not complain about postural low back pain, but rather had radiculopathy because of compression by the migrated rod. The presence of a presumable adequate arthrodesis induced us to remove the fixation system. For safety we performed only a minimally invasive vertebroplasty without hardware replacement, since spine stability had already been achieved (). This bone formation provided adequate arthrodesis and spine stability, but did not prevent the rods migration inside the bony tunnel. This condition justifies the clinical picture because the patient did not complain about postural low back pain, but rather had radiculopathy because of compression by the migrated rod. The presence of a presumable adequate arthrodesis induced us to remove the fixation system. For safety we performed only a minimally invasive vertebroplasty without hardware replacement, since spine stability had already been achieved (<xref ref-type="fig" rid="cmo-6-2012-375f4">Figs. 4</xref> and and <xref ref-type="fig" rid="cmo-6-2012-375f5">5</xref>).).'], 'cmo-6-2012-375f5': ['The S1 radiculopathy and paresthesias disappeared in one month. The postoperative neuroimaging control (lumbar dynamic X-ray and MRI) showed no complications, while confirming the L3 vertebroplasty without any sign of spinal instability (<xref ref-type="fig" rid="cmo-6-2012-375f5">Fig. 5</xref>). The patient was discharged four days after the operation and she is still in good condition at one-year follow up, without any sign of clinical or radiological spine instability.). The patient was discharged four days after the operation and she is still in good condition at one-year follow up, without any sign of clinical or radiological spine instability.'], 'cmo-6-2012-375f3': ['Considering previous issues, any clinical disturbances should not be underestimated because they could be related to an instrumentation failure, even many years after the operation. This is especially true for patients submitted to spinal stabilization with metal devices, and, in general, all patients with prostheses. A further concern is that quite often this complication is misdiagnosed. It can be attributed to the basic disease, or to other more common disorders (eg, degenerative spine diseases). The rod migration responsible for the S1 radiculopathy was misdiagnosed for a long time because the physicians’ attention was directed to the theoretically more frequent lymphoma diffusion through the nerve sheath, rather than the rare instrumentation failure. Consequently, an MRI was chosen, as a neuroradiological study was presumably indicated. Even if, at a retrospective reevaluation of the MRI, the rod migration was evident in some slices, a simple lumbar spine X-ray would allow us to make the definitive diagnosis (<xref ref-type="fig" rid="cmo-6-2012-375f3">Fig. 3</xref>).).']} | An Unusual Instrumentation-Related S1 Radiculopathy in a Patient Treated for a Primary Vertebral (L3) Lymphoma | [
"primary bone lymphoma",
"spine stabilization",
"hardware failure",
"misdiagnosed clinical picture"
] | Clin Med Insights Oncol | 1353312000 | A subset of CC chemokine receptor-6(+) (CCR6(+)), γδ-low (GDL) T cells that express Th17 cytokines in mouse skin participates in IL-23-induced psoriasiform dermatitis. We use CCR6-deficient (knockout, KO) and wild-type (WT) mice to analyze skin trafficking patterns of GDL T cells and function-blocking mAbs to determine the role of CCR6 in IL-23-mediated dermatitis. Herein, CCL20 was highly upregulated in IL-23-injected WT mouse ear skin as early as 24 hours after initial treatment, and large numbers of CCR6(+) cells were observed in the epidermis of IL-23-injected WT mice. Anti-CCL20 mAbs reduced psoriasiform dermatitis and blocked recruitment of GDL T cells to the epidermis. In CCR6 KO mice, GDL T cells failed to accumulate in the epidermis after IL-23 treatment, but the total numbers of GDL T cells in the dermis of WT and CCR6 KO mice were equivalent. There was an ∼70% reduction in the proportion of IL-22(+) GDL T cells in the dermis of CCR6 KO mice (vs WT mice), suggesting that effector function and epidermal recruitment of GDL T cells are impaired in CCR6-deficient mice. Thus, these data show that CCR6 regulates epidermal trafficking of γδ-T-cell subsets in the skin and suggest the potential of CCR6 as a therapeutic target for psoriasis. | [
"Animals",
"Antibodies, Blocking",
"Cell Movement",
"Chemokine CCL20",
"Dermatitis",
"Epidermis",
"Interleukin-23",
"Interleukins",
"Mice",
"Mice, Inbred C57BL",
"Mice, Knockout",
"Psoriasis",
"Receptors, Antigen, T-Cell, gamma-delta",
"Receptors, CCR6",
"T-Lymphocyte Subsets",
"Interleukin-22"
] | other | PMC3511055 | null | 32 | [
"{'Citation': 'Cai Y, Shen X, Ding C, Qi C, Li K, Li X, et al. Pivotal role of dermal IL-17-producing gammadelta T cells in skin inflammation. Immunity. 2011;35:596–610.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3205267'}, {'@IdType': 'pubmed', '#text': '21982596'}]}}",
"{'Citation': 'Caruso R, Botti E, Sarra M, Esposito M, Stolfi C, Diluvio L, et al. Involvement of interleukin-21 in the epidermal hyperplasia of psoriasis. Nat Med. 2009;15:1013–1015.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19684581'}}}",
"{'Citation': 'Chan JR, Blumenschein W, Murphy E, Diveu C, Wiekowski M, Abbondanzo S, et al. IL-23 stimulates epidermal hyperplasia via TNF and IL-20R2-dependent mechanisms with implications for psoriasis pathogenesis. J Exp Med. 2006;203:2577–87.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2118145'}, {'@IdType': 'pubmed', '#text': '17074928'}]}}",
"{'Citation': 'Cua DJ, Tato CM. Innate IL-17-producing cells: The sentinels of the immune system. Nat Rev Immunol. 2010;10:479–489.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20559326'}}}",
"{'Citation': 'Elhofy A, Depaolo RW, Lira SA, Lukacs NW, Karpus WJ. Mice deficient for CCR6 fail to control chronic experimental autoimmune encephalomyelitis. J Neuroimmunol. 2009;213:91–99.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2728039'}, {'@IdType': 'pubmed', '#text': '19535153'}]}}",
"{'Citation': 'Fitch E, Harper E, Skorcheva I, Kurtz SE, Blauvelt A. Pathophysiology of psoriasis: Recent advances on IL-23 and Th17 cytokines. Curr Rheumatol Rep. 2007;9:461–7.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2893221'}, {'@IdType': 'pubmed', '#text': '18177599'}]}}",
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] | Clin Med Insights Oncol. 2012 Nov 19; 6:375-380 | NO-CC CODE |
|
CT scanned images of four patients monitored for 5 years of MSC therapy—A Before MSC therapy, some fibrillation was observed. Radiologic changes included linear fibrosis, bronchiectasis, air bronchogram, ground-glass opacities isolated areas of pleural thickening, and hydrothorax post-MSC transplantation for B 1 week, C 24 weeks, D 1 year, and E 5 years. After MSC transplantation for 24 weeks and one year, all patients showed improvement on CT. Reproduced from [72] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0) | 11010_2022_4601_Fig3_HTML | 7 | 85fe6fcbefb610584a6129b5590c1d547e2634a84b178d73d47f3fa478d454ca | 11010_2022_4601_Fig3_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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"computerized tomography"
] | [
676,
354
] | [{'image_id': '11010_2022_4601_Fig2_HTML', 'image_file_name': '11010_2022_4601_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig2_HTML.jpg', 'caption': 'I CT scanned images of lung tissue of LPS-induced ARDS in the rabbit.\xa0(A)\xa0Transverse section of the lung.\xa0(B)\xa0Inflamed lungs were observed in the control group.\xa0(C)\xa0Decreased inflammation in the lungs after stem cell treatment. II Necropsy and histopathological findings in the LPS-induced ARDS in the rabbit.\xa0(A–E)\xa0Control group.\xa0(A)\xa0Lung tissue is showing hyperemia, hemorrhage, and edema.\xa0(B)\xa0Interstitial edema and pneumonia (arrow). (B, C) Inflammatory cell infiltration (arrowhead).\xa0(D)\xa0Hyperemia and severe hemorrhage in alveoli and parenchyma (arrows).\xa0(E)\xa0Myofibrils necrosis of heart (arrow).\xa0(F–K)\xa0Treatment group. (F) Lung tissue showing hyperemia and edema (lesser than in the control group). (G–I) Histopathological staining depicts lesser alveoli and parenchymal damage.\xa0(K)\xa0Heart without injured lesions. Reproduced from [61] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)', 'hash': '5f868d07b0b6991a91c305a06d0393020280b8d886da638e764681f44eebe338'}, {'image_id': '11010_2022_4601_Fig5_HTML', 'image_file_name': '11010_2022_4601_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig5_HTML.jpg', 'caption': 'Examination of infected lungs of COVID-19 patient. On Jan 23, no signs of pneumonia were observed. On Jan 30, ground-glass opacity and pneumonia infiltration was observed on multiple lobes of the lungs. After 2\xa0days of MSC treatment, on Feb 2, pneumonia invaded the whole lung, which had gradually reduced (Feb 9 and Feb 15). Reproduced from [96] and reprinted from Creative Commons Attribution License', 'hash': 'baa528954739a11fa08fc11ecee5fbcbdbe0487d57e7ef6d5ababd63a6d1012f'}, {'image_id': '11010_2022_4601_Fig3_HTML', 'image_file_name': '11010_2022_4601_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig3_HTML.jpg', 'caption': 'CT scanned images of four patients monitored for 5\xa0years of MSC therapy—A Before MSC therapy, some fibrillation was observed. Radiologic changes included linear fibrosis, bronchiectasis, air bronchogram, ground-glass opacities isolated areas of pleural thickening, and hydrothorax post-MSC transplantation for B 1\xa0week, C 24\xa0weeks, D 1\xa0year, and E 5\xa0years. After MSC transplantation for 24\xa0weeks and one year, all patients showed improvement on CT. Reproduced from [72] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)', 'hash': '85fe6fcbefb610584a6129b5590c1d547e2634a84b178d73d47f3fa478d454ca'}, {'image_id': '11010_2022_4601_Figa_HTML', 'image_file_name': '11010_2022_4601_Figa_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Figa_HTML.jpg', 'caption': 'No caption found', 'hash': 'd44945380dc115826e4765eb52a069f70048aa7a02e83b744d00469a61e92d5d'}, {'image_id': '11010_2022_4601_Fig4_HTML', 'image_file_name': '11010_2022_4601_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig4_HTML.jpg', 'caption': 'Graph representing the clinical trials registered till 30th of March 2022 based on the origin of stem cells for COVID-19 therapy', 'hash': '0261708c86368746a64ddea2f610e5d190e056a6a5eef0849e1731836674c6bf'}, {'image_id': '11010_2022_4601_Fig8_HTML', 'image_file_name': '11010_2022_4601_Fig8_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig8_HTML.jpg', 'caption': 'Immunopathogenesis of the coronavirus and the therapeutic potential of the MSC and their exosomes. Coronavirus infects ACE2-expressing cells and type II alveolar epithelial cells. The influx of T-cells, neutrophils, macrophages, and B-cells is induced by cytokines and chemokines secretion. The localization of the inflammatory cells at the injured site further leads to the production of pro-inflammatory cytokines, which is known as a cytokine storm, that acts as a major reason for ARDS in COVID-19. These inflammatory responses may cause lung fibrosis, apoptosis of the alveolar cells, edema, and organ failure. Immunomodulatory properties of stem cells are transferred to the injured site through exosomes that reduce inflammation-induced lung injury. The immunomodulatory properties of MSCs and their exosomes suppress inflammation and reduce inflammation-induced lung injury. Once the infected cells move into the bloodstream, the virus can move to many other organs causing various conditions. This figure was adapted from reference [118, 119]', 'hash': 'bf175a03fadf4d818add3df410b865e3c90d65acd7563576e8300ee065713808'}, {'image_id': '11010_2022_4601_Fig7_HTML', 'image_file_name': '11010_2022_4601_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig7_HTML.jpg', 'caption': 'Chest CT images of the COVID-19 patients before and after stem cell treatment. I: CT images of the COVID-19 patient\xa0(A-1–A-4) before the treatment indicates ground-glass opacity (GGO), and pneumonia infiltration was observed throughout the lungs.\xa0B-1–B-4\xa0images indicate the symptoms of the patient are slightly reduced, but the pneumonia was still significant. And after cell transplantation, images showed a decrease in pneumonia, lightening, and disappearance of ground-glass opacity. Reproduced from [100] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)', 'hash': 'a0f9d2d25685203f9be7b5f6d051899268dfc3ba48bf29dcdc52491667da867d'}, {'image_id': '11010_2022_4601_Fig6_HTML', 'image_file_name': '11010_2022_4601_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig6_HTML.jpg', 'caption': 'CT scanned images of hUC-MSC treated and control groups. CT imaging results for 6 patients at 3 time points (pretreatment, 1\xa0week after treatment, and 2\xa0weeks after treatment). The red arrows indicate inflammatory sites. The red triangles show the sites of the Crazy-paving pattern; the yellow triangles show the sites of consolidation; the blue triangles show the sites of GGO; the black triangles show the sites of interlobular septal thickening; the purple triangles show the sites of bronchial wall thickening. Reproduced from [97] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)', 'hash': '3a29dac1bb24cffc4754be680417ee21526fd3328e491a78ae0797797b4ebadf'}, {'image_id': '11010_2022_4601_Fig9_HTML', 'image_file_name': '11010_2022_4601_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig9_HTML.jpg', 'caption': 'SwIV influenza virus replication in lung epithelial cells. A, B Fluorescence and light microscopic images of Lung epithelial cells without influenza virus, Lung epithelial cells incubated with SwIV virus in DMEM media for 1\xa0h, Lung epithelial cells incubated with SwIV virus subjected to 10\xa0µg/ml MSC-EVs treatment for 1\xa0h. C Graph representing the number of viral nucleoproteins expressed cells post 8\xa0h of infection. D Virus titers of SwIV-infected cells and MSC-EV treated cells after 48\xa0h of infection evaluated by titration performed using MDCK cells. Reproduced from [121] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)', 'hash': '50baef5ccc6284b51e1fd52d0423d44d90ce7a5b80ed9dc6011694e8fa7b0688'}, {'image_id': '11010_2022_4601_Fig1_HTML', 'image_file_name': '11010_2022_4601_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC9672621/11010_2022_4601_Fig1_HTML.jpg', 'caption': 'Physiological changes occurred after stem cell injection. I X-rays images of saline-injected control group having no lesion in the lung tissue, LPS-induced rat depicting lung injury, hemorrhage, and inflammation, which were reduced after MenSC administration (LPS\u2009+\u2009MenSCs group). II H&E staining showing the pathological differences in the control group, LPS-induced group, and MenSC-treated group. III Lung dry/wet ratios of these models were evaluated. Scale bar: 50\xa0µm Reproduced from [58] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)', 'hash': 'c17952c18731f7e9cd1f2324641d9042e2ca3ab9c9d44e2b70534bc147586a54'}] | {'11010_2022_4601_Fig1_HTML': ['A combination of hUC-MSCs and FTY720 (a novel immunosuppressive agent) was investigated by Huang et al. in an LPS-induced lung injury mouse model. The clinical efficacy in alleviating lung injuries was higher with the combination treatment of hUC-MSCs and FTY720 than with using hUC-MSCs or FTY720 alone. Transcriptomic analysis by using a gene expression chip identified potential gene targets Nr1h4, Nol3, Cyp17a1, Prkg2, and Rps6ka6 related to ALI/ARDS [57]. Genetic expression analysis enabled the highlight of the possible genes involved in the aggravation of the infection. Thus, this study speculates that targeting these genes may provide alleviation to COVID-19 patients. Xiang et al. investigated the Menstrual Blood-Derived Mesenchymal Stem Cells (MenSCs) in treating LPS-induced ALI (Fig.\xa0<xref rid="11010_2022_4601_Fig1_HTML" ref-type="fig">1</xref>). In the LPS-induced mice model, decreased inflammation and a severe reduction in the BALF were observed [). In the LPS-induced mice model, decreased inflammation and a severe reduction in the BALF were observed [58]. MenSCs may have reduced the inflammation which was observed in the histological tissues. Even though therapies might provide promisable results in pre-clinical studies, using menstrual blood for stem cell isolation is still dilemmatic. Due to sources of stem cell isolation, there is a requirement to use antibiotics to avoid secondary infections. Thus, there is uncertainty about the interference of these antibiotics in stem cell-based therapies. One of the major limitations of using MenSC is reproducibility, and each woman may have a different menstrual cycle and hormonal changes, which depend on the characteristics of the stem cells. Thus, the potential of the therapy may differ even between doses in the same patient.Fig. 1Physiological changes occurred after stem cell injection. I X-rays images of saline-injected control group having no lesion in the lung tissue, LPS-induced rat depicting lung injury, hemorrhage, and inflammation, which were reduced after MenSC administration (LPS\u2009+\u2009MenSCs group). II H&E staining showing the pathological differences in the control group, LPS-induced group, and MenSC-treated group. III Lung dry/wet ratios of these models were evaluated. Scale bar: 50\xa0µm Reproduced from [58] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)'], '11010_2022_4601_Fig2_HTML': ['Mokhber Dezfouli et al. emphasized the beneficial effect of intrapulmonary autologous transplantation of bone marrow-derived mesenchymal stromal cells in treating LPS-induced ARDS in rabbits (Fig.\xa0<xref rid="11010_2022_4601_Fig2_HTML" ref-type="fig">2</xref>). They confirmed that MSCs decrease the severity of clinical symptoms and inflammation. Lung CT images showed decreased inflammation and mucous accumulation, which was confirmed by cytokine profiling. (Fig.\xa0). They confirmed that MSCs decrease the severity of clinical symptoms and inflammation. Lung CT images showed decreased inflammation and mucous accumulation, which was confirmed by cytokine profiling. (Fig.\xa0<xref rid="11010_2022_4601_Fig2_HTML" ref-type="fig">2</xref>I). After MSC administration, inflammatory cytokines (TNF-α and IL-6) were found to be reduced in the blood and BAL. Necropsy and histopathological staining also further confirmed that no injury was observed in the treatment group (Fig.\xa0I). After MSC administration, inflammatory cytokines (TNF-α and IL-6) were found to be reduced in the blood and BAL. Necropsy and histopathological staining also further confirmed that no injury was observed in the treatment group (Fig.\xa0<xref rid="11010_2022_4601_Fig2_HTML" ref-type="fig">2</xref>II) [II) [61].Fig. 2I CT scanned images of lung tissue of LPS-induced ARDS in the rabbit.\xa0(A)\xa0Transverse section of the lung.\xa0(B)\xa0Inflamed lungs were observed in the control group.\xa0(C)\xa0Decreased inflammation in the lungs after stem cell treatment. II Necropsy and histopathological findings in the LPS-induced ARDS in the rabbit.\xa0(A–E)\xa0Control group.\xa0(A)\xa0Lung tissue is showing hyperemia, hemorrhage, and edema.\xa0(B)\xa0Interstitial edema and pneumonia (arrow). (B, C) Inflammatory cell infiltration (arrowhead).\xa0(D)\xa0Hyperemia and severe hemorrhage in alveoli and parenchyma (arrows).\xa0(E)\xa0Myofibrils necrosis of heart (arrow).\xa0(F–K)\xa0Treatment group. (F) Lung tissue showing hyperemia and edema (lesser than in the control group). (G–I) Histopathological staining depicts lesser alveoli and parenchymal damage.\xa0(K)\xa0Heart without injured lesions. Reproduced from [61] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)'], '11010_2022_4601_Fig3_HTML': ['According to several clinical study reports, more than 80% of COVID patients had lymphopenia, and more than 50% of ICU patients had high levels of TNF-α and granulocyte colony-stimulating factors, two of the major causes of a cytokine storm [70]. Another study was conducted by Liu et al., where they investigated the clinical pathology and progression of SARS-CoV-2-infected ARDS patients. There were 109 COVID patients of the following categories: the elderly and those complicated with secondary diseases like diabetes, cerebrovascular disease, and kidney diseases. It was found that in each of these conditions, there are higher chances of acquiring SARS-CoV-2-induced ARDS [71]. Consequently, it is necessary to understand stem cell therapy for ARDS and ALI. A single-centered, open-labeled clinical trial was conducted for H7N9-induced ARDS in 17 patients. The mortality rate in the MSC-transplanted patients was significantly lowered in the experimental group. Before MSC treatment, the patients showed ground-glass opacities and fibrillations in the chest radiography images. After the treatment, radiographic images were followed up at different intervals, i.e., 1\xa0week, 24\xa0weeks, 1\xa0year, and 5\xa0years (Fig.\xa0<xref rid="11010_2022_4601_Fig3_HTML" ref-type="fig">3</xref>). The patients started to improve after 1\xa0week of treatment. Additionally, it was observed that MSC therapy did not have any adverse effects on the patients even after 5\xa0years of follow-up (Fig.\xa0). The patients started to improve after 1\xa0week of treatment. Additionally, it was observed that MSC therapy did not have any adverse effects on the patients even after 5\xa0years of follow-up (Fig.\xa0<xref rid="11010_2022_4601_Fig3_HTML" ref-type="fig">3</xref>E) [E) [72]. Hence, it can also be believed that stem cell-based therapies would provide beneficial results. The mode of action of stem cell therapies involves inhibiting the virus-induced cytokine storm by regulating macrophages (M1 phenotype), suppressing T-cells activation, increasing the concentration of Treg cells, suppressing dendritic cells, hampering NK cell-mediated cell lysis, affecting B-cell proliferation and antibody production, decreasing the levels of inflammatory factors, increasing anti-inflammatory factors, and regenerating injured tissues.Fig. 3CT scanned images of four patients monitored for 5\xa0years of MSC therapy—A Before MSC therapy, some fibrillation was observed. Radiologic changes included linear fibrosis, bronchiectasis, air bronchogram, ground-glass opacities isolated areas of pleural thickening, and hydrothorax post-MSC transplantation for B 1\xa0week, C 24\xa0weeks, D 1\xa0year, and E 5\xa0years. After MSC transplantation for 24\xa0weeks and one year, all patients showed improvement on CT. Reproduced from [72] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)'], '11010_2022_4601_Fig4_HTML': ['As of March 30th, 2022, there are 86 clinical trials registered on ClinicalTrials.gov. The table below is a comprehensive list of all the clinical studies (Supplementary Information Table S1) (Fig.\xa0<xref rid="11010_2022_4601_Fig4_HTML" ref-type="fig">4</xref>) [) [78]. In our analysis, it is found that BM-MSCs (24 cases) and UC-MSCs (20 cases) are extensively used for stem cell-based therapy for COVID-19. However, now the question arises as to which stem cells could provide better results or promise better results and are suitable for the treatment. Or will there be any difference overall in treatment when stem cells are derived from different origins? Or which of these cells provides more concentration of anti-inflammatory by-products? Which cells are better obtained without many ethical issues? These are some of the questions that need to be answered when assessing both cells for treatments. Lee et al. compare the immunomodulatory effect of placenta-derived mesenchymal stem cells (P-MSCs) with BM-MSCs and AD-MSCs, and the study reveals that P-MSCs have much higher immunomodulatory capability than BM-MSCs and AD-MSCs [79]. However, the availability of P-MSCs is very scare due to a lack of awareness of placental stem cell banking is limited [80]. Furthermore, Atluri et al. also predict that hUC-MSCs could be the best source for COVID-19 treatments. UC-MSCs are better than BM-MSCs due to availability, scalability, faster doubling time, and non-invasive extraction [81]. Other than these two major cell types, few cases were also performed by cardiosphere derived cells (CDCs) [82], olfactory mucosal lining derived MSCs (OM-MSCs) [36], Haematopoietic stem cells (HSCs) [83], Stem Cell\xa0Educator-Treated Mononuclear\xa0Cells\xa0(SCE-MCs) [84], CAStem cells [Immunity- and matrix-regulatory cells (IMRCs) derived from ESCs] [85], P-MSCs [86], Extracorporeal derived MSC [87], DP-MSCs [88], AD-MSCs [89]. In the cases of CDCs, OM-MSCs, and HSCs, there is always a concern about whether these cells would differentiate into their respective lineages rather than perform their immunomodulation function. Furthermore, SCE-MCs function was quite different from the usual stem cell therapy. Stem Cell Educator (SCE) technology was patented by Tianhe Stem Cell Biotechnologies for treating autoimmune diseases like Type 1 diabetes, Alopecia Areata. SCE uses multipotent cord blood stem cells (CB-SCs). CB-SCs have proven their immunomodulatory properties in some autoimmune disorders. Because the properties of CB-SCs differ from those of other stem cells, researchers are attempting to incorporate these CB-SCs in order to combat COVID-19. However, this study is still in the preliminary stage [84]. Cell-free therapy has also undergone a clinical trial platform, and there were four studies that used exosomes or extracellular vesicles as their drug for intervention [90–93]. Out of these two studies was for the nasal route is their mode of drug delivery, which might be highly recommendable since coronavirus also targets the lung most [91, 92]. If the anti-inflammatory factors and growth factors from exosomes could target more of the lesions of the injured lung tissue, then this method may prove more advantageous than intravenous drug delivery.Fig. 4Graph representing the clinical trials registered till 30th of March 2022 based on the origin of stem cells for COVID-19 therapy'], '11010_2022_4601_Fig5_HTML': ['A recent study conducted by Leng et al. demonstrated the potential clinical benefits of MSCs transplantation in 7 COVID-19 pneumonia patients (2 common, 4 severe, 1 critically severe) (Fig.\xa0<xref rid="11010_2022_4601_Fig5_HTML" ref-type="fig">5</xref>). MSCs (1\u2009×\u200910). MSCs (1\u2009×\u2009106 cells/kg body weight) were transplanted by intravenous drip with saline, and patients were observed for 14-days. Remarkably, after 2–4\xa0days of MSC transplantation, symptoms like pyrexia and dyspnea disappeared. Also, there was a decline in C-reactive protein level, aspartic aminotransferase, creatine kinase activity, and myoglobin, which suggested an immediate recovery of pulmonary function. Furthermore, mass cytometry (CyTOF) analysis showed a decrease in the number of active CXCR3+CD4+ T-cells, CXCR3+ NK cells, and CXCR3+CD8+ T-cells and an increase in CD14+CD11c+CD11bmid regulatory DC cell population. Similarly, TNF-α was also significantly decreased, while anti-inflammatory cytokine IL-10 level increased along with an increase of chemokines IP-10 and VEGF, which suggests the ability of MSCs in controlling cytokine release syndrome. Importantly, this is the first report that shows the negative gene expression of ACE2 and TMPRSS2 in MSCs, which suggests the safety of MSCs in COVID-19 treatment [96].Fig. 5Examination of infected lungs of COVID-19 patient. On Jan 23, no signs of pneumonia were observed. On Jan 30, ground-glass opacity and pneumonia infiltration was observed on multiple lobes of the lungs. After 2\xa0days of MSC treatment, on Feb 2, pneumonia invaded the whole lung, which had gradually reduced (Feb 9 and Feb 15). Reproduced from [96] and reprinted from Creative Commons Attribution License'], '11010_2022_4601_Fig6_HTML': ['Shu et al. conducted a clinical study on COVID patients using intravenous infusion of hUC-MSCs (Fig.\xa0<xref rid="11010_2022_4601_Fig6_HTML" ref-type="fig">6</xref>) [) [97]. It was a single-center study where they found that the patients in the hUC-MSC treatment group recovered and improved, while three patients from the control group did not survive [97]. A similar study was also conducted by Meng et al., where they used UC-MSCs to treat 18 patients (9 in the treatment group and 9 in the control group). Both groups were provided with standard treatments. It was found that there was no adverse effect due to the administration of UC-MSCs. 2/9 of patients from the UC-MSC treatment group had shown symptoms of transient facial flushing and pyrexia. One of the patients suffered from transient hypoxia after 12\xa0h of UC-MSCs administration [98].Fig. 6CT scanned images of hUC-MSC treated and control groups. CT imaging results for 6 patients at 3 time points (pretreatment, 1\xa0week after treatment, and 2\xa0weeks after treatment). The red arrows indicate inflammatory sites. The red triangles show the sites of the Crazy-paving pattern; the yellow triangles show the sites of consolidation; the blue triangles show the sites of GGO; the black triangles show the sites of interlobular septal thickening; the purple triangles show the sites of bronchial wall thickening. Reproduced from [97] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)'], '11010_2022_4601_Fig7_HTML': ['Another case in China, where COVID-19 pneumonia was treated by human umbilical cord Wharton’s jelly-derived MSCs. Before the treatment, the patient showed round-glass opacity and pneumonia filtration in both lungs. Along with this, a crazy-paving pattern was observed due to GGO with inter and intralobular septal thickening. Both these symptoms were reduced drastically after the intravenous infusion of WJ-MSCs. The patient improved significantly with a decrease in the symptoms, and gradual recovery of pulmonary function was observed post 1\xa0week of discharge [100] (Fig.\xa0<xref rid="11010_2022_4601_Fig7_HTML" ref-type="fig">7</xref>).).Fig. 7Chest CT images of the COVID-19 patients before and after stem cell treatment. I: CT images of the COVID-19 patient\xa0(A-1–A-4) before the treatment indicates ground-glass opacity (GGO), and pneumonia infiltration was observed throughout the lungs.\xa0B-1–B-4\xa0images indicate the symptoms of the patient are slightly reduced, but the pneumonia was still significant. And after cell transplantation, images showed a decrease in pneumonia, lightening, and disappearance of ground-glass opacity. Reproduced from [100] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)'], '11010_2022_4601_Fig8_HTML': ['Another advancement of stem cell therapy is cell-free therapy using extracellular vesicles (EVs) of stem cells. Cell-free therapy is based on considering stem cells as a source for extracting therapeutic molecules such as EVs/MVs/exosomes instead of the whole stem cell as a therapeutic agent [111]. One of the advantages of cell-free therapies is these molecules can be formulated such that they can be administered as inhalants [112]. The International Society for Aerosols in Medicine (ISAM) recommends that in COVID-19, the primary route of infection is through the lungs, and inhalation as a route of delivery could lead to an effective treatment strategy [113]. Moreover, this route of delivery is being administered before the COVID-19 pandemic for other lung cancer diseases like asthma, COPD, cystic fibrosis, pneumonia, pulmonary hypertension, and ARDS [114]. Every cell ejects EVs in the form of exosomes (40–150\xa0nm in diameter) or microvesicles (150–1000\xa0nm in diameter) (MVs) [115]. The physiological function of EVs is communication, cell signaling, and defense [44]. MVs are products of exocytosis of the plasma membrane along with cellular components and cytoplasm, whereas exosomes originate from multivesicular bodies that are formed during endosomal maturation. Like MVs, exosomes also contain cellular components [116]. As mentioned earlier, stem cell-based therapy works on paracrine-based signaling. Similarly, EVs are regulated via the paracrine effect. However, one of the major advantages of cell-free therapies is that there is no risk of tumorigenicity and lower immunogenicity [115]. And there are various types of RNAs in the cytoplasm of a cell. Some of these RNAs are also likely to get trapped in the EVs. It was observed that EVs predominantly contain rRNAs, however, quantities of mRNAs, miRNAs, and tRNAs are relatively lesser [117]. The physiological and biological activities of exosomes are conserved and similar to those of their parent stem cells. EVs also possess anti-apoptotic, immunomodulatory, angiogenic, and tissue-regenerating functions [117]. Figure\xa0<xref rid="11010_2022_4601_Fig8_HTML" ref-type="fig">8</xref> depicts the immunopathology of COVID-19 and attempts to decipher the possible strategies of stem cells and their exosome-based therapy. depicts the immunopathology of COVID-19 and attempts to decipher the possible strategies of stem cells and their exosome-based therapy.Fig. 8Immunopathogenesis of the coronavirus and the therapeutic potential of the MSC and their exosomes. Coronavirus infects ACE2-expressing cells and type II alveolar epithelial cells. The influx of T-cells, neutrophils, macrophages, and B-cells is induced by cytokines and chemokines secretion. The localization of the inflammatory cells at the injured site further leads to the production of pro-inflammatory cytokines, which is known as a cytokine storm, that acts as a major reason for ARDS in COVID-19. These inflammatory responses may cause lung fibrosis, apoptosis of the alveolar cells, edema, and organ failure. Immunomodulatory properties of stem cells are transferred to the injured site through exosomes that reduce inflammation-induced lung injury. The immunomodulatory properties of MSCs and their exosomes suppress inflammation and reduce inflammation-induced lung injury. Once the infected cells move into the bloodstream, the virus can move to many other organs causing various conditions. This figure was adapted from reference [118, 119]'], '11010_2022_4601_Fig9_HTML': ['In a study conducted by Khatri et al., they studied the attenuation of the Influenza A-induced lung injury model in pigs by BM-MSCs-derived EVs [121] (Fig.\xa0<xref rid="11010_2022_4601_Fig9_HTML" ref-type="fig">9</xref>). In vitro hemagglutination studies of different types of Influenza virus strains (swine/TX/98; H3N2, human/CA/09; H1N1, gull/MD/1995; H9N5, swine/MN/08; H1N1, chicken/NY/H7N2) were studied, and it was observed that EVs showed complete inhibition of hemagglutination activity within 1.25 and 5\xa0μg/ml concentrations. MSC-EVs also drastically reduced the apoptosis of influenza-infected lung epithelial cells. In the SwIV-induced acute lung injury pig model, after 12\xa0h of intratracheal administration of MSC-EVs (80\xa0μg/kg body weight), there was a reduction of influenza virus infection by 100-folds. Anti-inflammatory cytokine IL-10 expression was increased while associated inflammatory cytokines (TNF-α and CXCL10) were reduced by BM-MSCs derived EVs [). In vitro hemagglutination studies of different types of Influenza virus strains (swine/TX/98; H3N2, human/CA/09; H1N1, gull/MD/1995; H9N5, swine/MN/08; H1N1, chicken/NY/H7N2) were studied, and it was observed that EVs showed complete inhibition of hemagglutination activity within 1.25 and 5\xa0μg/ml concentrations. MSC-EVs also drastically reduced the apoptosis of influenza-infected lung epithelial cells. In the SwIV-induced acute lung injury pig model, after 12\xa0h of intratracheal administration of MSC-EVs (80\xa0μg/kg body weight), there was a reduction of influenza virus infection by 100-folds. Anti-inflammatory cytokine IL-10 expression was increased while associated inflammatory cytokines (TNF-α and CXCL10) were reduced by BM-MSCs derived EVs [121]. EVs show improved results in treating respiratory-related diseases in in vitro and in vivo conditions. These studies show that there are possibilities for using cell-free therapies to treat ARDS for COVID-19, and Table 4 supports the use of cell-free therapies. In the current scenario, limited clinical trials are being performed using exosomes derived from MSCs.Fig. 9SwIV influenza virus replication in lung epithelial cells. A, B Fluorescence and light microscopic images of Lung epithelial cells without influenza virus, Lung epithelial cells incubated with SwIV virus in DMEM media for 1\xa0h, Lung epithelial cells incubated with SwIV virus subjected to 10\xa0µg/ml MSC-EVs treatment for 1\xa0h. C Graph representing the number of viral nucleoproteins expressed cells post 8\xa0h of infection. D Virus titers of SwIV-infected cells and MSC-EV treated cells after 48\xa0h of infection evaluated by titration performed using MDCK cells. Reproduced from [121] and reprinted from Creative Commons Attribution 4.0 licence (CC BY-4.0)Table 4Comprehensive depiction of preclinical cases of using cell-free therapies in COVID-19Source of MSC-EV or MSC-MV or MSC-exosomesAnimal modelsType of injury modelRoute of delivery and dosageKey findings/outcomeReferenceshBM-MSCs-EVsC57Bl/6 male miceLPS inducedMVs released by 7.5\u2009×\u2009105 cells/ml∙ mtDNA transfer from MSC to alveolar macrophage diminished TNF-a and IL-8 production by 58\u2009±\u20098% and 30\u2009±\u200915%∙ Levels of the M2 chemokinesCCL18 (68\u2009±\u200921% reduction) and CCL22 (79\u2009±\u200912% reduction)[211]C57Bl/6 male miceE. coli endotoxin inducedIntravenous1\u2009×\u20091010 EVs∙ EV increased phagocytic ability in immune cells∙ EVs decreased MRP1 (multidrug resistant associated protein-1) expression and increased LTB4 (leukotriene B4) levels in BALF[212]hBM-MSCs-EVs from ARDS patients and healthy donorsCD1 male miceLPS inducedThree doses0.8\u2009×\u2009103/ml1.6\u2009×\u2009103/ml and3.2\u2009×\u2009103/ml∙ EVsARDS had higher levels of (TβRI)/Alk5 and the Runx1 transcription factor[213]hBM-MSCs-EVs and mBM-MSCs-EVsC57Bl/6 miceAspergillus hyphal induced allergic airway inflammationIntravenousEVs released by 3\u2009×\u2009107 cells/200\xa0µl∙ Significantly ameliorated airway hyperreactivity, lung inflammation, and the antigen-specific CD4 T-cell Th2 and Th17 phenotype∙ EVs from hBM-MSCs were more effective than hMSCs in reducing levels of IL-12 and chemokine keratinocyte chemoattractant (KC) in BALF∙ Levels of IL-10 were increased by both EVs and stem cells[214]hUC-MSC-EVs and hUC-MSCSprague–Dawley female ratsHyperoxic inducedIntratrachealBased on the severity of the rats—8\u2009×\u2009108 EVs/g4.5\u2009×\u2009108 EVs/g3\u2009×\u2009108 EVs/g∙ hUC-MSC-EVs and hUC-MSC reduced hypoxia induced damage∙ EVs were better in terms of alveolarization and lung vascularization parameters[215]hUC-MSC (naïve)-EVs and hUC-MSC (INF-γ activated)-EVsSprague–Dawley male ratsE. coli inducedIntravenous3–4\u2009×\u2009107 EVs∙ hUC-MSC (INF-γ activated)-EVs were more effective in attenuating than hUC-MSC (naive)-EVs∙ Reduced alveolar protein leak, increased lung mononuclear phagocytes, enhanced endothelial nitric oxide synthase production[216]hAD-MSC-EVs (young and aged donor)C57Bl/6 miceLPS inducedIntravenousEVs—100\xa0µg/200\xa0µlhAD-MSC-EVs—1\u2009×\u2009106 cells/200\xa0µl∙ Young hAD-MSC-EVs reduced the inflammatory cell accumulation and alveolar septal thickness∙ Young hAD-MSC-EVs Significantly reduced protein, total cells, and neutrophils (by 37.4%, 43.2%, 42.8%, respectively) in the BALF∙ Aged hAD-MSCs and aged hAD-MSC-EVs failed to show beneficial results[217]hBM-MSCs-MVsC57Bl/6 male miceE. coli K1 inducedIntravenousMVs released by 9\u2009×\u2009106 cells/90\xa0µl∙ Enhanced monocyte phagocytosis of bacteria, reduced the influx of leukocytes by 40%, neutrophils by 53% and decreased the total protein concentration by 22% in the BALF∙ Decreased inflammatory cytokine secretion and increased intracellular ATP levels in injured alveolar epithelial type 2 cells[218]Ang-1 siRNA hBM-MSC MVs and hBM-MSC MVsC57Bl/6 male miceLPS inducedIntratrachealMVs released by 1\u2009×\u2009106 cells/10\xa0µl∙ Ang-1 mRNA deficient MVsincreased the influx of neutrophils and MIP-2 levels in BALF∙ bBM-MSC-MVs restored the pulmonary capillary permeability decreases levels of TNF-α and increased levels of IL-10[219]hMSCs-MVsC57Bl/6 male miceE. coli endotoxin inducedIntratrachealMVs released by 7.5\u2009×\u2009105 cells/30\xa0µl∙ MVs reduced extravascular lung water by 43% and reduced total protein levels in the BALF by 35%∙ Reduced the influx of neutrophils and MIP-2 levels in the BALF by 73% and 49% respectively∙ KGF siRNA pre-treated MSCs restricted the release of MVs thus states the importance of KGF[220]hUC-MSC-MVs and downregulated miR100-hUC-MSC-MVsSprague–Dawley male ratsBleomycin inducedIntratracheal1\u2009×\u2009106 MVs/10\xa0µl∙ hUC-MSC-MVs elevated the miR-100 levels, whereas downregulated miR100-hUC-MSC-MVs inhibited the mi-R100 levels∙ hUC-MSC-MVs reduced levels of LC3 II and Beclin-1[221]hUC-MSC derived exosomeBALB/C female miceAvian influenza A (H5N1) inducedIntravenousExosomes released by 5\u2009×\u2009105 cells∙ hUC-MSCs are more efficient than hBM-MSCs in correcting impaired alveolar fluid clearance and alveolar protein permeability∙ Reduced IL-6, IFN-β, IFN-γ1, MCP-1, ISG-15, IL-1β, IP-10, Mx-1, RANTES, and increased the levels of IL-4, IL-10, IL-11, IL-13, IL-1RA[44]hAD-MSC derived exosomesSprague–Dawley ratsHypoxia inducedIntraperitoneal3.4\u2009×\u2009109 exosomes/50\xa0µl∙ Enhanced lung blood vessel density and reduce RV hypertrophy∙ Exosome injection preserved alveolar growth in hyperoxia exposure rats[222]mBM-MSCs derived exosomes and mBM-MSCsSprague–Dawley male ratsIntestinal ischemia–reperfusion inducedSubcutaneous5–10\xa0μg/500\xa0μl∙ Levels of pro-inflammatory cytokines like TNF-α, IL-6, and IL-1β were decreased∙ Reduced expression of decreased TLR4 and NF-κB levels in rat lung tissue∙ Both EVs and whole MSCs showed similar results[223]mRNA-30b-3p-overexpressing mBM-MSCs derived exosomesC57Bl/6 miceLPS inductionIntravenous100\xa0µg/200\xa0µl∙ Alleviation was observed in edema and thickening of alveolar septum, alveolar hemorrhage, alveolar wall and inflammatory cell infiltration by mRNA-30b-3p overexpressing mBM-MSCs exosomes∙ Reduction of SAA3, IL-1β, TNF-α, IL-6 and increase of IL-10 was greater in mRNA-30b-3p overexpressing mBM-MSCs exosomes than mBM-MSCs exosomes[224]mAD-MSC derived exosomesSprague–Dawley male ratsSepsis syndrome induction by cecal ligation and punctureIntravenous100\xa0µg purified from mAD-MSCs∙ Lower levels of CD11b/c/Ly6G/MIF (macrophage migration inhibitor factor) were found in blood and BALF[225,226]']} | Pooled evidence from preclinical and clinical studies for stem cell-based therapy in ARDS and COVID-19 | [
"SARS-CoV2",
"COVID-19",
"Stem cell therapy",
"Immunomodulation",
"Stem cell-free therapy"
] | Mol Cell Biochem | 1700208000 | This study uses mobile phone data to examine how socioeconomic status was associated with the extent of mobility reduction during the spring 2020 lockdown in England in a manner that considers both potentially confounding effects and spatial dependency and heterogeneity. It shows that socioeconomic status as approximated through income and occupation was strongly correlated with the extent of mobility reduction. It also demonstrates that the specific nature of the association of socioeconomic status with mobility reduction varied markedly across England. Finally, the analysis suggests that the spatial differentiation in the ability to restrict everyday mobility in response to a national lockdown is an important topic for future research. | [
"COVID-19",
"Communicable Disease Control",
"England",
"Epidemics",
"Humans",
"Pandemics",
"Social Behavior",
"Social Class",
"Socioeconomic Factors",
"Spatial Analysis"
] | other | PMC9672621 | null | 71 | [
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] | Mol Cell Biochem. 2023 Nov 17; 478(7):1487-1518 | NO-CC CODE |
|
Examples of mid-sagittal MRI images and statistical outcomes from several of the conditions described in this review. All images are oriented with anterior to the left; a complete AgCC; b partial AgCC; c statistical significance of smaller CC area in 22qDS than controls (Fig. 4d in (Machado et al. 2007)); d CC hypoplasia in an individual born preterm (Fig. 2 in (Nosarti et al. 2004)); e significance of mean local CC area reveals significantly smaller anterior third of callosum in autistic subjects relative to control subjects (Fig. 2c in (Vidal et al. 2006)) | 11689_2010_9059_Fig2_HTML | 7 | 7e5ea384c59192c77bc79436c17cf291790606d328bcc48f755f480d6185aba6 | 11689_2010_9059_Fig2_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
488,
407
] | [{'image_id': '11689_2010_9059_Fig2_HTML', 'image_file_name': '11689_2010_9059_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC3163989/11689_2010_9059_Fig2_HTML.jpg', 'caption': 'Examples of mid-sagittal MRI images and statistical outcomes from several of the conditions described in this review. All images are oriented with anterior to the left; a complete AgCC; b partial AgCC; c statistical significance of smaller CC area in 22qDS than controls (Fig.\xa04d in (Machado et al. 2007)); d CC hypoplasia in an individual born preterm (Fig.\xa02 in (Nosarti et al. 2004)); e significance of mean local CC area reveals significantly smaller anterior third of callosum in autistic subjects relative to control subjects (Fig.\xa02c in (Vidal et al. 2006))', 'hash': '7e5ea384c59192c77bc79436c17cf291790606d328bcc48f755f480d6185aba6'}, {'image_id': '11689_2010_9059_Fig1_HTML', 'image_file_name': '11689_2010_9059_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC3163989/11689_2010_9059_Fig1_HTML.jpg', 'caption': 'Fractional anisotropy maps of mid-sagittal corpus callosum with overlay of all discernable fibers projecting out to specific cortical areas. Four female subjects on right and four male subjects on left. Color-scheme of projections is as follows: prefrontal lobe (green), premotor and supplementary motor areas (light blue), primary motor cortex (dark blue), primary sensory cortex (red), parietal lobe (orange), occipital lobe (yellow), and temporal lobe (violet). Extracted from Fig.\xa02 in (Hofer and Frahm 2006)', 'hash': 'f912ad9e29b2172d1cc06d813d8eff0879f121c3239ce981517062fc7663a2de'}] | {'11689_2010_9059_Fig1_HTML': ['The corpus callosum is topographically organized, such that fibers connecting a given cortical area are adjacent (Moses et al. 2000; Pandya et al. 1971; Witelson 1989; Tovar-Moll et al. 2007). Regional organization of the CC is most commonly described using the geometric classification scheme delimited by Witelson’s histological studies. However, diffusion-weighted magnetic resonance imaging (dMRI) analyzed in conjunction with histologic data has provided clarification of callosal microstructure and connectivity, resulting in an updated variation of Witelson’s segmentation (Fig.\xa0<xref rid="11689_2010_9059_Fig1_HTML" ref-type="fig">1</xref>) (Hofer and Frahm ) (Hofer and Frahm 2006). Although Witelson’s descriptions of cortical-callosal connections were not entirely accurate, her classification terms remain broadly accepted and will be used herein, but will be used in reference to the cortical-callosal connections described below.\nFig.\xa01Fractional anisotropy maps of mid-sagittal corpus callosum with overlay of all discernable fibers projecting out to specific cortical areas. Four female subjects on right and four male subjects on left. Color-scheme of projections is as follows: prefrontal lobe (green), premotor and supplementary motor areas (light blue), primary motor cortex (dark blue), primary sensory cortex (red), parietal lobe (orange), occipital lobe (yellow), and temporal lobe (violet). Extracted from Fig.\xa0<xref rid="11689_2010_9059_Fig2_HTML" ref-type="fig">2</xref> in (Hofer and Frahm in (Hofer and Frahm 2006)Fig.\xa02Examples of mid-sagittal MRI images and statistical outcomes from several of the conditions described in this review. All images are oriented with anterior to the left; a complete AgCC; b partial AgCC; c statistical significance of smaller CC area in 22qDS than controls (Fig.\xa04d in (Machado et al. 2007)); d CC hypoplasia in an individual born preterm (Fig.\xa02 in (Nosarti et al. 2004)); e significance of mean local CC area reveals significantly smaller anterior third of callosum in autistic subjects relative to control subjects (Fig.\xa02c in (Vidal et al. 2006))', 'The directional information from dMRI can also be integrated through space, in a process referred to as virtual fiber tractography. MRI fiber tractography is now widely used to map non-invasively the long-range structural connectivity of the human brain and it works very well for identifying larger fiber tracts that are highly organized in a single direction. However, current fiber tracking algorithms are inadequate for following multiple fiber paths when they pass through the same area. This so-called crossing fiber problem (Basser et al. 2000; Wiegell et al. 2000; Behrens et al. 2007) is the primary limitation for tracing the fibers of the CC out of the CC proper (Basser et al. 2000; Hofer and Frahm 2006; Johansen-Berg et al. 2007). Tractography identifies CC connections to the dorsal and medial cortical surface (for example, see Fig.\xa0<xref rid="11689_2010_9059_Fig1_HTML" ref-type="fig">1</xref>) but does not reveal lateral callosal projections, presumably because lateral callosal projections cross through association fiber bundles with different orientations (for example, the longitudinal fasciculus and internal capsule). Despite this limitation, several recent studies have used dMRI and tract-tracing statistics to segment callosal regions according to the cortical areas they connect in an individual subject (Cascio et al. ) but does not reveal lateral callosal projections, presumably because lateral callosal projections cross through association fiber bundles with different orientations (for example, the longitudinal fasciculus and internal capsule). Despite this limitation, several recent studies have used dMRI and tract-tracing statistics to segment callosal regions according to the cortical areas they connect in an individual subject (Cascio et al. 2006; Huang et al. 2005; Dougherty et al. 2007). This approach has great promise when used wisely, remembering that lateral callosal projections are likely to be under-represented.']} | Developmental malformation of the corpus callosum: a review of typical callosal development and examples of developmental disorders with callosal involvement | [
"Corpus callosum",
"White matter",
"Brain connectivity",
"Neuroanatomy",
"Interhemispheric"
] | J Neurodev Disord | 1300863600 | 22q11.2 deletion syndrome (22q11DS) is a genetic disorder associated with a microdeletion of chromosome 22q11. In addition to high rates of neuropsychiatric disorders such as schizophrenia and attention deficit hyperactivity disorder, children with 22q11DS have a specific neuropsychological profile with particular deficits in visuospatial and working memory. However, the neurobiological substrate underlying these deficits is poorly understood. We investigated brain function during a visuospatial working memory (SWM) task in eight children with 22q11DS and 13 healthy controls, using fMRI. Both groups showed task-related activation in dorsolateral prefrontal cortex (DLPFC) and bilateral parietal association cortices. Controls activated parietal and occipital regions significantly more than those with 22q11DS but there was no significant between-group difference in DLPFC. In addition, while controls had a significant age-related increase in the activation of posterior brain regions and an age-related decrease in anterior regions, the 22q11DS children showed the opposite pattern. Genetically determined differences in the development of specific brain systems may underpin the cognitive deficits in 22q11DS, and may contribute to the later development of neuropsychiatric disorders. | [] | other | PMC3163989 | null | 73 | [
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] | J Neurodev Disord. 2011 Mar 23; 3(1):3-27 | NO-CC CODE |
|
Comparison between the original and pre-processed image. | gr4_lrg | 7 | 881f826999aa3b99e991a225223e21e3bf40373b527ff6b7ee05253920baa9c0 | gr4_lrg.jpg | multiple | multiple panels: images | [
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The preprocessing pipeline was initially applied to the raw CT scan images. Data scaling, shuffles, noise removal, image sharpening, normalizing, brightness and contrast adjustments were made in the pre-processing pipeline. The preprocessed data set was then partitioned into two sets of training dataset and testing dataset, where one set was used to train transfer-learning-based models, and another set was used for the proposed Triplet Siamese Network. After each epoch, the training accuracy and loss were computed. Validation accuracy and loss were simultaneously found using 10-fold cross-validation. The confusion matrix, accuracy, ROC AUC, specificity, sensitivity, and F1-score were utilized to test the performance of the suggested system.\n. The preprocessing pipeline was initially applied to the raw CT scan images. Data scaling, shuffles, noise removal, image sharpening, normalizing, brightness and contrast adjustments were made in the pre-processing pipeline. The preprocessed data set was then partitioned into two sets of training dataset and testing dataset, where one set was used to train transfer-learning-based models, and another set was used for the proposed Triplet Siamese Network. After each epoch, the training accuracy and loss were computed. Validation accuracy and loss were simultaneously found using 10-fold cross-validation. The confusion matrix, accuracy, ROC AUC, specificity, sensitivity, and F1-score were utilized to test the performance of the suggested system.Fig. 1Pipeline to develop the proposed model.Fig. 1'], 'gr2_lrg': ['<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref> and and <xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>\nshows input image for the models.\nshows input image for the models.Fig. 2Input Data Visualization for transfer-learning-based CNN models.Fig. 2Fig. 3Input Data Visualization for the proposed framework.Fig. 3'], 'gr4_lrg': ['Thus, by solving α and β introducing α and β to the images using saturation arithmetics, we were able to improve brightness and contrast. <xref rid="gr4_lrg" ref-type="fig">Fig. 4</xref>\nshows us the effect of data pre-processing on the original dataset.\nshows us the effect of data pre-processing on the original dataset.Fig. 4Comparison between the original and pre-processed image.Fig. 4'], 'gr5_lrg': ['The Triplet Siamese Network, a Siamese network with three identical subnetworks, is used in this research. We fed the model three images, two of which were similar (anchor and positive samples) while the third was dissimilar (a negative example). A representation of this concept has been shown in <xref rid="gr5_lrg" ref-type="fig">Fig. 5</xref>\n.\n.Fig. 5Triplet input (anchor, positive and negative).Fig. 5'], 'gr6_lrg': ['Every model generated embeddings independently, and the concatenation of embeddings was fed into a neural network of 512 neurons to reduce the generalization error of the extraction. <xref rid="gr6_lrg" ref-type="fig">Fig. 6</xref>\nillustrates the proposed model architecture.\nillustrates the proposed model architecture.Fig. 6Architecture of the proposed model.Fig. 6'], 'gr7_lrg': ['The high-level architecture of the proposed model to diagnose COVID-19, CAP, and Normal has been presented in <xref rid="gr7_lrg" ref-type="fig">Fig. 7</xref>\n. It includes the ensemble of models for feature embedding, similarity learning with Margin Ranking loss, and the training process.\n. It includes the ensemble of models for feature embedding, similarity learning with Margin Ranking loss, and the training process.Fig. 7An illustration of the proposed model.Fig. 7'], 'gr8_lrg': ['As shown in Table 4, our suggested model outperforms the implemented pre-trained models with a substantially better score. The result is more significant because the proposed model\'s score was obtained from 10152 images, whereas the other models were tested with only 3390 images. Furthermore, compared to pre-trained CNN models, the suggested model\'s training and validation loss seem more stable and better convergent, as illustrated in <xref rid="gr8_lrg" ref-type="fig">Fig. 8</xref>\n. We have used the L2 dropout regularization strategy to prevent our model from overfitting to training data. Early stopping was employed with a learning schedule (the ReduceLROnPlateau callback from Pytorch) to prevent overfitting. \n. We have used the L2 dropout regularization strategy to prevent our model from overfitting to training data. Early stopping was employed with a learning schedule (the ReduceLROnPlateau callback from Pytorch) to prevent overfitting. Table 6\nsummarizes the classification performance results for additional verification of the performance of our proposed model on a class-by-class basis. A graphical representation of Table 6 has been given in <xref rid="gr9_lrg" ref-type="fig">Fig. 9</xref>\n.\n.Fig. 8Training vs. validation loss of pre-trained CNN models and the proposed model.Fig. 8Table 6The class-wise score of the proposed model.Table 6LabelsPrecisionRecallF1 scoreAUC ROCAccuracySpecificitysupportCAP0.99580.97280.98420.99890.98960.99793384Normal0.97450.99470.98450.99930.98960.98703384COVID0.99170.99410.99290.99960.99530.99593384Micro avg0.98720.98720.98720.999010152Macro avg0.98730.98720.98720.999210152Weighted avg0.98730.98720.987210152Samples avg0.98720.98720.987210152Fig. 9Graphical representation of the class-wise score.Fig. 9'], 'gr10_lrg': ['The confusion matrix from the model\'s inference stage is shown in <xref rid="gr10_lrg" ref-type="fig">Fig. 10</xref>\n. Only 28 COVID-19 images out of 10152 were incorrectly classified, which is better than human classification. As a result, COVID-19 instances may be classified effectively using the suggested approach.\n. Only 28 COVID-19 images out of 10152 were incorrectly classified, which is better than human classification. As a result, COVID-19 instances may be classified effectively using the suggested approach.Fig. 10Confusion matrix of the CovidExpert.Fig. 10'], 'gr11_lrg': ['Additionally, the ROC curves are shown in <xref rid="gr11_lrg" ref-type="fig">Fig. 11</xref>\nto assess the overall efficacy by summarizing the trade-off between true positives and false positive rates. The suggested architecture\'s Receiver Operating Characteristic (ROC) curve was estimated to be 99.9%, demonstrating the CovidExpert\'s exceptional diagnostic capacity.\nto assess the overall efficacy by summarizing the trade-off between true positives and false positive rates. The suggested architecture\'s Receiver Operating Characteristic (ROC) curve was estimated to be 99.9%, demonstrating the CovidExpert\'s exceptional diagnostic capacity.Fig. 11ROC curve of the proposed system.Fig. 11'], 'gr12_lrg': ['For all conceivable threshold values, the precision-recall (PR) curve in <xref rid="gr12_lrg" ref-type="fig">Fig. 12</xref>\ndisplays the precision vs. the recall (true positive rate). High recall and high precision are desired outcomes. Similar trade-offs exist between high precision and high recall; when threshold is lowered, recall increases but precision decreases.\ndisplays the precision vs. the recall (true positive rate). High recall and high precision are desired outcomes. Similar trade-offs exist between high precision and high recall; when threshold is lowered, recall increases but precision decreases.Fig. 12PR curve of the proposed system.Fig. 12'], 'gr13_lrg': ['A graphical user interface (GUI) was developed for model inference. Several images from the test dataset were predicted using the GUI. The model uses Cosine similarity to measure the similarity between the input image and a similar image from the query set. The model\'s inference on six images is shown in <xref rid="gr13_lrg" ref-type="fig">Fig. 13</xref>, , <xref rid="gr14_lrg" ref-type="fig">Fig. 14</xref>\n.\n.Fig. 13Correct predictions.Fig. 13Fig. 14Wrong predictions.Fig. 14']} | CovidExpert: A Triplet Siamese Neural Network framework for the detection of COVID-19 | [
"COVID-19 diagnosis",
"Few-shot learning",
"CT scan images",
"Triplet siamese network",
"Ensemble CNN"
] | Inform Med Unlocked | 1673596800 | None | null | other | PMC9837208 | null | null | [
""
] | Inform Med Unlocked. 2023 Jan 13; 37:101156 | NO-CC CODE |
|
CT in a child with acute lymphatic leukemia with ARDS: multiple pulmonary nodules, several of which are cavitating (arrow), findings that raise specificity for opportunistic fungal infection. | 978-1-4419-0922-0_27_Fig5_Print | 7 | 74b056a3ab3266b19c54b1ac68ed4e2cdd81d143acc73beb54b1264aef18a787 | 978-1-4419-0922-0_27_Fig5_Print.jpg | multiple | multiple panels: images | [
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"computerized tomography"
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121
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Ultrasound images (B, C) demonstrate this collection to be complex (grade 2), with loculations, echogenic fluid, and fibrous adhesions.', 'hash': '603674bd13e4e326d0ed60603cdac9ecdee391aa8aebf9aa948fc84153672755'}, {'image_id': '978-1-4419-0922-0_27_Fig1_Print', 'image_file_name': '978-1-4419-0922-0_27_Fig1_Print.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig1_Print.jpg', 'caption': 'Diagnostic and therapeutic imaging workup algorithm for pneumonia with pleural effusion in immunocompetent children.', 'hash': '91d638bbd7a2ae72fdc162d337670bf199b76327ff4593fbcd4e2823d7ab5aba'}, {'image_id': '978-1-4419-0922-0_27_Fig3_Print', 'image_file_name': '978-1-4419-0922-0_27_Fig3_Print.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig3_Print.jpg', 'caption': 'Empyema: role of CT. Radiograph (A) and CT (B) demonstrate left-sided pleural collection with mass effect, consistent with empyema. Radiograph (C) and CJ (D) following chest tube placement show thickening of the visceral pleura consistent with pleural, fibrosis (organization phase, grade 3), preventing full expansion of the left lung.', 'hash': '7c43842b9c250c13a33d1993333999d6c6db7fd0669872e77707f03145b2b608'}, {'image_id': '978-1-4419-0922-0_27_Fig2_Print', 'image_file_name': '978-1-4419-0922-0_27_Fig2_Print.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig2_Print.jpg', 'caption': 'Empyema: role of ultrasound. Chest radiograph (A) shows left-sided pleural collection. Ultrasound images (B, C) demonstrate this collection to be complex (grade 2), with loculations, echogenic fluid, and fibrous adhesions.', 'hash': '691a90b53322c8b99051883d2c80a25562e4bf2ddbe37562a2700fc50cac63d6'}, {'image_id': '978-1-4419-0922-0_27_Fig5_Print', 'image_file_name': '978-1-4419-0922-0_27_Fig5_Print.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig5_Print.jpg', 'caption': 'CT in a child with acute lymphatic leukemia with ARDS: multiple pulmonary nodules, several of which are cavitating (arrow), findings that raise specificity for opportunistic fungal infection.', 'hash': '74b056a3ab3266b19c54b1ac68ed4e2cdd81d143acc73beb54b1264aef18a787'}, {'image_id': '978-1-4419-0922-0_27_Fig4_Print', 'image_file_name': '978-1-4419-0922-0_27_Fig4_Print.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig4_Print.jpg', 'caption': 'Use of CT to differentiate empyema from lung abscess. Radiograph (A) and CT (B) demonstrate a fluid collection with mass effect on the lung (arrows), which forms an obtuse angle with the pleura, consistent with a pleural abscess (empyema). Radiograph (C) and CT (D) demonstrate a gas- and fluid-containing lung mass, which forms a sharp angle with the pleura, confirming its intraparenchymal location.', 'hash': '2ed43593f088e5bf3bf311eb2a8f217d34cebae4e0c98ba82905f84cdd584f34'}, {'image_id': '978-1-4419-0922-0_27_Fig5_HTML', 'image_file_name': '978-1-4419-0922-0_27_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig5_HTML.jpg', 'caption': 'CT in a child with acute lymphatic leukemia with ARDS: multiple pulmonary nodules, several of which are cavitating (arrow), findings that raise specificity for opportunistic fungal infection.', 'hash': '083f14c4e6dbe68b6a3b3a520f0878e5d4f7b9eda4f73bc5c11ad56756f2bfc8'}, {'image_id': '978-1-4419-0922-0_27_Fig3_HTML', 'image_file_name': '978-1-4419-0922-0_27_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig3_HTML.jpg', 'caption': 'Empyema: role of CT. Radiograph (A) and CT (B) demonstrate left-sided pleural collection with mass effect, consistent with empyema. Radiograph (C) and CJ (D) following chest tube placement show thickening of the visceral pleura consistent with pleural, fibrosis (organization phase, grade 3), preventing full expansion of the left lung.', 'hash': '1912fa8c6306501d80fc8e857527de0921994c2df575b83735cbe5b376293dce'}, {'image_id': '978-1-4419-0922-0_27_Fig4_HTML', 'image_file_name': '978-1-4419-0922-0_27_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig4_HTML.jpg', 'caption': 'Use of CT to differentiate empyema from lung abscess. Radiograph (A) and CT (B) demonstrate a fluid collection with mass effect on the lung (arrows), which forms an obtuse angle with the pleura, consistent with a pleural abscess (empyema). Radiograph (C) and CT (D) demonstrate a gas- and fluid-containing lung mass, which forms a sharp angle with the pleura, confirming its intraparenchymal location.', 'hash': '54809a57698d48e17d13a394bc96eada63658a41ec83040c71284eb4aad9d1bd'}, {'image_id': '978-1-4419-0922-0_27_Fig1_HTML', 'image_file_name': '978-1-4419-0922-0_27_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7176188/978-1-4419-0922-0_27_Fig1_HTML.jpg', 'caption': 'Diagnostic and therapeutic imaging workup algorithm for pneumonia with pleural effusion in immunocompetent children.', 'hash': 'd02ab101b890a6c715b4ae87fe044f5e342dedb927568c4c4c2babac77e837a8'}] | {'978-1-4419-0922-0_27_Fig1_HTML': ['Figure <xref rid="978-1-4419-0922-0_27_Fig1_HTML" ref-type="fig">27.1</xref> is a diagnostic and therapeutic imaging workup algorithm for pneumonia with pleural effusion in immunocompetent children. Figures is a diagnostic and therapeutic imaging workup algorithm for pneumonia with pleural effusion in immunocompetent children. Figures <xref rid="978-1-4419-0922-0_27_Fig2_HTML" ref-type="fig">27.2</xref> and and <xref rid="978-1-4419-0922-0_27_Fig3_HTML" ref-type="fig">27.3</xref> show the role of ultra- show the role of ultra-Figure 27.1.Diagnostic and therapeutic imaging workup algorithm for pneumonia with pleural effusion in immunocompetent children.\nFigure 27.2.Empyema: role of ultrasound. Chest radiograph (A) shows left-sided pleural collection. Ultrasound images (B, C) demonstrate this collection to be complex (grade 2), with loculations, echogenic fluid, and fibrous adhesions.\nFigure 27.3.Empyema: role of CT. Radiograph (A) and CT (B) demonstrate left-sided pleural collection with mass effect, consistent with empyema. Radiograph (C) and CJ (D) following chest tube placement show thickening of the visceral pleura consistent with pleural, fibrosis (organization phase, grade 3), preventing full expansion of the left lung.\n'], '978-1-4419-0922-0_27_Fig4_HTML': ['sound and CT in empyema. Figure <xref rid="978-1-4419-0922-0_27_Fig4_HTML" ref-type="fig">27.4</xref> shows how CT can be used to differentiate empyema from lung abscess.\n shows how CT can be used to differentiate empyema from lung abscess.\nFigure 27.4.Use of CT to differentiate empyema from lung abscess. Radiograph (A) and CT (B) demonstrate a fluid collection with mass effect on the lung (arrows), which forms an obtuse angle with the pleura, consistent with a pleural abscess (empyema). Radiograph (C) and CT (D) demonstrate a gas- and fluid-containing lung mass, which forms a sharp angle with the pleura, confirming its intraparenchymal location.\n'], '978-1-4419-0922-0_27_Fig5_HTML': ['Figure <xref rid="978-1-4419-0922-0_27_Fig5_HTML" ref-type="fig">27.5</xref> presents CT in a child with acute lymphatic leukemia with ARDS.\n presents CT in a child with acute lymphatic leukemia with ARDS.\nFigure 27.5.CT in a child with acute lymphatic leukemia with ARDS: multiple pulmonary nodules, several of which are cavitating (arrow), findings that raise specificity for opportunistic fungal infection.\n']} | Imaging of Chest Infections in Children | [
"Pleural Effusion",
"Chest Radiograph",
"Chest Radiography",
"Pleural Fluid",
"Bacterial Pneumonia"
] | Evidence-Based Imaging in Pediatrics | 1276239600 | None | null | other | PMC7176188 | null | null | [
""
] | Evidence-Based Imaging in Pediatrics. 2010 Jun 11;:401-418 | NO-CC CODE |
|
Impressive splenomegaly in common variable immunodeficiency (CVID) reaching almost to the lower pole of the kidneys. Computed tomography (CT) of the chest/abdomen, coronal section© (2) Springer Medizin | 40629_2014_30_Fig4_HTML | 7 | 8c0c800c3711a5cc2cfca14beab994b35ed60be2e71f0a3aca9812aff5a6d05f | 40629_2014_30_Fig4_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
548,
720
] | [{'image_id': '40629_2014_30_Fig5_HTML', 'image_file_name': '40629_2014_30_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC4479546/40629_2014_30_Fig5_HTML.jpg', 'caption': 'Crohn’s disease-like chronic inflammatory bowel disease in common variable immunodeficiency (CVID). Coloscopy', 'hash': '8c5de09eb611e61f548f7a31c99c4e8410a98d55bd1ba70118b35661edfd26b5'}, {'image_id': '40629_2014_30_Fig2_HTML', 'image_file_name': '40629_2014_30_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC4479546/40629_2014_30_Fig2_HTML.jpg', 'caption': 'Invasive aspergillosis with brain abscess in the right parieto-occipital lobe. 2b: Histology with direct pathogen detection, predominantly in combined immune defects and WAS', 'hash': 'f971b425ab4b1638dbed552083716c9af887b3da8344d5a1d48048b20f04ada3'}, {'image_id': '40629_2014_30_Fig4_HTML', 'image_file_name': '40629_2014_30_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC4479546/40629_2014_30_Fig4_HTML.jpg', 'caption': 'Impressive splenomegaly in common variable immunodeficiency (CVID) reaching almost to the lower pole of the kidneys. Computed tomography (CT) of the chest/abdomen, coronal section© (2) Springer Medizin', 'hash': '8c0c800c3711a5cc2cfca14beab994b35ed60be2e71f0a3aca9812aff5a6d05f'}, {'image_id': '40629_2014_30_Fig3_HTML', 'image_file_name': '40629_2014_30_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC4479546/40629_2014_30_Fig3_HTML.jpg', 'caption': 'Mediastinal lymphadenopathy in common variable immunodeficiency (CVID). Computed tomography (CT) of the chest', 'hash': '14a8e46aa6095c85e27beaacc3761176f21b30a26d6bc3615f4cb8a23fbe0dc9'}, {'image_id': '40629_2014_30_Fig1_HTML', 'image_file_name': '40629_2014_30_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC4479546/40629_2014_30_Fig1_HTML.jpg', 'caption': 'Bilateral interstitial pneumonia with Pneumocystis jirovecii, seen predominantly in combined immunodeficiency© (4) Springer Medizin', 'hash': '0d7969b6e209ae7a75d93dc2e0471410140adc86a480b8bb4de1f100ee3d1bd9'}] | {'40629_2014_30_Fig1_HTML': ['Pathogen (Erreger): Infections due to opportunistic pathogens such as Pneumocystis jirovecii (Fig. <xref rid="40629_2014_30_Fig1_HTML" ref-type="fig">1</xref>) should prompt suspicion of ID.) should prompt suspicion of ID.'], '40629_2014_30_Fig2_HTML': ['Localization (Lokalisation): Atypical localization of the infection, e. g., brain abscess due to Aspergillus (Fig. <xref rid="40629_2014_30_Fig2_HTML" ref-type="fig">2</xref>), cerebral toxoplasmosis, or pneumococcal arthritis, are suggestive of ID.), cerebral toxoplasmosis, or pneumococcal arthritis, are suggestive of ID.'], '40629_2014_30_Fig3_HTML': ['Lymphoproliferative disorders (Lymphoproliferation): chronic benign lymphadenopathy, splenomegaly (Figs. <xref rid="40629_2014_30_Fig3_HTML" ref-type="fig">3</xref> and and <xref rid="40629_2014_30_Fig4_HTML" ref-type="fig">4</xref>))'], '40629_2014_30_Fig5_HTML': ['Inflammatory bowel disease (Darmentzündung): often early-onset, atypical, refractory to therapy (Fig. <xref rid="40629_2014_30_Fig5_HTML" ref-type="fig">5</xref>))']} | Immunodeficiency in adults a practical guide for the allergist | [
"immune defects",
"immunodeficiency",
"warning signs",
"early detection",
"therapy",
"immunoglobulin",
"autoimmunity"
] | Allergo J Int | 1415260800 | All cranial placode progenitors arise from a common precursor field anterior to the neural plate, the pre-placodal region (PPR). We showed that transcription factor Zic1, expressed at the anterior neural plate, is necessary and sufficient to promote placode fate. Here we reveal the non-cell autonomous activity of Zic1 and implicate retinoic acid (RA) signalling as a key player in cranial placode progenitor specification. In a screen for genes activated by Zic1, we identify several factors involved in RA metabolism and function. Among them we show that retinaldehyde dehydrogenase 2 (RALDH2) and lipocalin-type prostaglandin D2 synthase (LPGDS), which, respectively, regulate the synthesis and transport of RA, directly participate in the establishment of the PPR. We propose that RALDH2 and LPGDS induction by Zic1 at the anterior neural plate allows for the localized production and transport of RA, which in turn activates a cranial placode developmental programme in neighbouring cells. | [
"Aldehyde Dehydrogenase 1 Family",
"Aldehyde Oxidase",
"Animals",
"Ectoderm",
"Embryo, Nonmammalian",
"Gene Expression Regulation, Developmental",
"In Situ Hybridization",
"Intramolecular Oxidoreductases",
"Lipocalins",
"Neural Plate",
"Neurogenesis",
"RNA, Messenger",
"Real-Time Polymerase Chain Reaction",
"Retinal Dehydrogenase",
"Signal Transduction",
"Stem Cells",
"Transcription Factors",
"Tretinoin",
"Xenopus Proteins",
"Xenopus laevis"
] | other | PMC4479546 | null | 60 | [
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"{'Citation': 'Maurus D, Harris WA. Zic-associated holoprosencephaly: zebrafish Zic1 controls midline formation and forebrain patterning by regulating Nodal, Hedgehog, and retinoic acid signaling. Genes & Dev. 2009;23:1461–1473.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2701571'}, {'@IdType': 'pubmed', '#text': '19528322'}]}}",
"{'Citation': 'Kolm PJ, Sive HL. Efficient hormone-inducible protein function in Xenopus laevis. Dev Biol. 1995;171:267–272.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7556904'}}}",
"{'Citation': 'Nieuwkoop PD, Faber J. Normal table of Xenopus leavis. North Holland Publishing Company; Amsterdam: 1967.'}",
"{'Citation': 'Slack JM, Forman D. An interaction between dorsal and ventral regions of the marginal zone in early amphibian embryos. J Embr Exp Morph. 1980;56:283–299.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7400747'}}}",
"{'Citation': 'Harland RM. In situ hybridization: an improved whole-mount method for Xenopus embryos. Methods Cell Biol. 1991;36:685–695.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1811161'}}}",
"{'Citation': 'Henry GL, Brivanlou IH, Kessler DS, Hemmati-Brivanlou A, Melton DA. TGF-beta signals and a pattern in Xenopus laevis endodermal development. Development. 1996;122:1007–1015.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8631246'}}}"
] | Allergo J Int. 2014 Nov 6; 23(7):261-268 | NO-CC CODE |
|
(a,b) A 41-year-old woman with a history of ALL found on clinical examination to have painless proptosis of the right eye. CT of the brain shows a sinus mass that has eroded through the lamina papyracea and cribriform plate. It is displacing the ocular muscles and optic nerve. Imaging of the orbits after intensive chemotherapy demonstrated complete resolution of the infiltrative lesion. | ci13000408 | 7 | db0bda560ac49a4178f012a06c6025f3acdd970872d46a812d8db9990fccfc8b | ci13000408.jpg | multiple | multiple panels: images | [
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721,
326
] | [{'image_id': 'ci13000407', 'image_file_name': 'ci13000407.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000407.jpg', 'caption': '(a,b) A 28-year-old man in remission from B-cell ALL with clinically palpable supraclavicular lymph nodes. CT demonstrated a 12-cm length of proximal jejunum with tumour invasion, aneurysmal dilatation and without obstruction. The patient subsequently had an excellent response to chemotherapy.', 'hash': '6a7c6af00d55bace557a505189d15c0e79578166783b875695129e4c501a8ad8'}, {'image_id': 'ci13000409', 'image_file_name': 'ci13000409.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000409.jpg', 'caption': 'A 26-year-old woman with a previous history of AML whose treatment included bone marrow transplantation. Clinical examination showed a palpable abdominal mass. CT of the abdomen demonstrated a large subcutaneous deposit. Ultrasound-guided biopsy confirmed granulocytic sarcoma. A small second focus of increased attenuation in the left flank was also felt likely to represent a second focus of recurrence; this was not biopsied at the time, however.', 'hash': '3c75e1a5050d1854474ecad887b6dd8cefd6e42daf86ad692e35bcbefc98952e'}, {'image_id': 'ci13000408', 'image_file_name': 'ci13000408.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000408.jpg', 'caption': '(a,b) A 41-year-old woman with a history of ALL found on clinical examination to have painless proptosis of the right eye. CT of the brain shows a sinus mass that has eroded through the lamina papyracea and cribriform plate. It is displacing the ocular muscles and optic nerve. Imaging of the orbits after intensive chemotherapy demonstrated complete resolution of the infiltrative lesion.', 'hash': 'db0bda560ac49a4178f012a06c6025f3acdd970872d46a812d8db9990fccfc8b'}, {'image_id': 'ci13000406', 'image_file_name': 'ci13000406.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000406.jpg', 'caption': 'A 44-year-old man with a previous history of B-cell ALL. The patient had a complicated course after a successful bone marrow transplant. He developed obstructive hydrocephalous secondary to subarachnoid haemorrhage for which 2 ventriculoperitoneal shunts were placed. At the same presentation, his lumbar puncture demonstrated immature lymphocytes consistent with CNS recurrence of his ALL; this was successfully treated. Two years later, the patient represented with a palpable left upper quadrant mass. (a) Axial and (b0 coronal CT images demonstrate an irregular soft tissue mass in the left upper quadrant with diffuse mesenteric infiltration. (c) A hypoechoic soft tissue mass on ultrasonography, which on biopsy, proved to recurrent extramedullary B-cell ALL. Clinically, it was hypothesized that this peritoneal recurrence was iatrogenic, likely secondary to placement of the ventriculoperitoneal shunt. (d,e) A 26-year-old woman with previously treated AML. The patient represented with abdominal discomfort particularly in the pelvis and left upper quadrant. CT demonstrated a left upper quadrant mass and a second mass in the pelvis that was causing bilateral hydronephrosis. MRI of the pelvis demonstrated a well-defined heterogeneous mass within the pelvis that enhanced markedly after contrast. CT-guided biopsies of pelvic and right upper quadrant masses confirmed granulocytic sarcoma.', 'hash': '572fadcb6b507ea92c8b7eed9e41425755e7c9ddb04e3b6ba7883b5b9820d29b'}, {'image_id': 'ci13000401', 'image_file_name': 'ci13000401.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000401.jpg', 'caption': 'Basic treatment pathway.', 'hash': 'a26749363866b0b4d9d3413d3f1a6c9c88672c17e2a1bb46477b608ec13c5691'}, {'image_id': 'ci13000402', 'image_file_name': 'ci13000402.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000402.jpg', 'caption': '(a,b) A 25-year-old woman with previous AML after bone marrow transplant presented with left leg pain. Nerve conduction studies were consistent with left sciatic nerve compression. T2-weighted fat-saturated sequences demonstrate an elongated spindle-shaped enhancing soft tissue mass measuring 2\u2009×\u20092\u2009cm axially and extending 14\u2009cm craniocaudally in the flexor compartment of the thigh. The mass completely resolved after chemotherapy.', 'hash': 'bbe938cfa80d4fcbc07023589fbe71eadd41e3390c5a40d136b24c68727e50ec'}, {'image_id': 'ci13000405', 'image_file_name': 'ci13000405.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000405.jpg', 'caption': 'A 22-year-old man with a background of T-cell ALL presented with bilateral sudden loss of vision. CT showed bilateral nodular enhancing optic nerve lesions consistent with disease recurrence.', 'hash': 'c2d45c9a0b86a8dd25c2a7fdb40fd8b343d04b66bde20122eaf97e8e35809e2b'}, {'image_id': 'ci13000404', 'image_file_name': 'ci13000404.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000404.jpg', 'caption': 'A 28-year-old man with a previous history of ALL presented 2 years after diagnosis and chemotherapy with subtle induration of the left testicle on clinical examination. (a–c) Ultrasonography demonstrated extensive low attenuation lesions within both testes replacing approximately 50% of the right testicle and 75% of the left with significant associated increased vascularity within the abnormal areas. The findings are consistent with an extramedullary leukemic recurrence.', 'hash': 'bf616714db6de6cf2e5ac0e008dbfc77de21016e038a1e99a4c776d44c46207a'}, {'image_id': 'ci13000403', 'image_file_name': 'ci13000403.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000403.jpg', 'caption': '(a) Breast ultrasonograph of a 41-year-old woman with a history of ALL found on clinical examination to have multiple palpable bilateral breast masses. The ultrasound image demonstrates a heterogeneous hypoechoic mass in the left breast. Similar masses were demonstrated in the right breast. (b) Mammogram on the same patient demonstrates lesions are isodense with surrounding breast parenchyma and not readily appreciable. Subsequent bilateral breast biopsy was positive for extramedullary recurrence of ALL. (c) Breast ultrasonograph of a 25-year-old woman with a previous history of AML. Clinical examination revealed a palpable mass in the left breast. Ultrasonography demonstrated a unilateral well-defined hypoechoic mass with posterior enhancement. Histology confirmed recurrent AML of the breast.', 'hash': 'eea0ae657bda9268e1cc19be2dfd82bad7a9a8c7d207ad7ed510f033d48de5bc'}] | {'ci13000401': ['Treatment of leukaemias consists of induction therapy and post-remission therapy. Complex multiple agent regimens are used with the aim of rapidly restoring bone marrow function, preventing the development of resistant cell lines and treating sanctuary sites such as the CNS as relapse is associated with a poor prognosis. Induction therapy should reduce the leukaemia cell population to below cytologically detectable levels. A substantial cytologically unmeasurable population can remain after initial therapy, which will lead to disease relapse and is countered with post-remission therapy. The choice of post-remission therapy is determined by the patients’ risk of relapse and involves consolidation chemotherapy, autologous and allogenic haematopoietic stem cell transplantation. Patients are categorized as low, intermediate or high risk of recurrence according to their clinical, cytological and cytogenetic profiles[24–31]. A simplified overview is demonstrated in <xref ref-type="fig" rid="ci13000401">Fig. 1</xref>.\n.\nFigure 1Basic treatment pathway.'], 'ci13000402': ['Peripheral nervous system (<xref ref-type="fig" rid="ci13000402">Fig. 2</xref>A,B) involvement in recurrent extramedullary disease is rarely reported in the literature. Documented presentations include mono- and polyneuropathies and small patient numbers mean that there are currently no definitive imaging findings for this group of patientsA,B) involvement in recurrent extramedullary disease is rarely reported in the literature. Documented presentations include mono- and polyneuropathies and small patient numbers mean that there are currently no definitive imaging findings for this group of patients[36–38].\nFigure 2(a,b) A 25-year-old woman with previous AML after bone marrow transplant presented with left leg pain. Nerve conduction studies were consistent with left sciatic nerve compression. T2-weighted fat-saturated sequences demonstrate an elongated spindle-shaped enhancing soft tissue mass measuring 2\u2009×\u20092\u2009cm axially and extending 14\u2009cm craniocaudally in the flexor compartment of the thigh. The mass completely resolved after chemotherapy.'], 'ci13000403': ['Leukaemic infiltrations of the breast (<xref ref-type="fig" rid="ci13000403">Fig. 3</xref>A–D) are reported to account for only 4% of metastatic deposits from primary extra-mammary malignancyA–D) are reported to account for only 4% of metastatic deposits from primary extra-mammary malignancy[39]. Mammographic appearance is non-specific, usually evident as asymmetry. Ultrasonographic findings consist of ill-defined shadows similar to invasive lobular carcinoma although in comparison with leukaemic masses, an echogenic margin can be seen[40]. Lesions are typically heterogeneous in appearance, with ill-defined margins. Acoustic shadowing may be present or absent[11,41]. Relapse of AML to the breast is more common than ALL, and those cases of ALL breast recurrence that do occur are most often bilateral[41]. Definitive differentiation from other breast lesions is difficult on imaging alone although a history of previous leukaemia should increase clinical suspicion for a possible unusual re-presentation.\nFigure 3(a) Breast ultrasonograph of a 41-year-old woman with a history of ALL found on clinical examination to have multiple palpable bilateral breast masses. The ultrasound image demonstrates a heterogeneous hypoechoic mass in the left breast. Similar masses were demonstrated in the right breast. (b) Mammogram on the same patient demonstrates lesions are isodense with surrounding breast parenchyma and not readily appreciable. Subsequent bilateral breast biopsy was positive for extramedullary recurrence of ALL. (c) Breast ultrasonograph of a 25-year-old woman with a previous history of AML. Clinical examination revealed a palpable mass in the left breast. Ultrasonography demonstrated a unilateral well-defined hypoechoic mass with posterior enhancement. Histology confirmed recurrent AML of the breast.'], 'ci13000404': ['The testicles, being a sanctuary site, are the most common location of extramedullary leukaemic recurrence in males (<xref ref-type="fig" rid="ci13000404">Fig. 4</xref>A–C). It occurs most commonly in the first 2–3 years of the primary disease although recurrence has been reported 19 years after initial diagnosis. In those with testicular recurrence, clinical assessment reveals bilateral involvement in 30% and histology shows bilateral involvement in 80%. Typical ultrasonographic appearances are of enlarged hypervascular testes. They may be of homogeneous echogenicity, especially when small, but often show diffuse or focal hypoechoic lesions replacing normal testicular tissueA–C). It occurs most commonly in the first 2–3 years of the primary disease although recurrence has been reported 19 years after initial diagnosis. In those with testicular recurrence, clinical assessment reveals bilateral involvement in 30% and histology shows bilateral involvement in 80%. Typical ultrasonographic appearances are of enlarged hypervascular testes. They may be of homogeneous echogenicity, especially when small, but often show diffuse or focal hypoechoic lesions replacing normal testicular tissue[11,42,43]. A clinical history of previous leukaemia should raise high clinical suspicion for recurrence, although sonographic appearances can also include differentials of seminomatous tumours, orchitis and testicular abscess[44].\nFigure 4A 28-year-old man with a previous history of ALL presented 2 years after diagnosis and chemotherapy with subtle induration of the left testicle on clinical examination. (a–c) Ultrasonography demonstrated extensive low attenuation lesions within both testes replacing approximately 50% of the right testicle and 75% of the left with significant associated increased vascularity within the abnormal areas. The findings are consistent with an extramedullary leukemic recurrence.'], 'ci13000405': ['Orbital involvement of relapsed disease is common and often presents as painless proptosis (<xref ref-type="fig" rid="ci13000405">Fig. 5</xref>). It is usually identified as a homogeneous mass, may be bilateral and can involve bony erosion, most often of the medial orbital wall. It may also arise outside the orbit and invade into it from the adjacent structures). It is usually identified as a homogeneous mass, may be bilateral and can involve bony erosion, most often of the medial orbital wall. It may also arise outside the orbit and invade into it from the adjacent structures[32,43,45].\nFigure 5A 22-year-old man with a background of T-cell ALL presented with bilateral sudden loss of vision. CT showed bilateral nodular enhancing optic nerve lesions consistent with disease recurrence.'], 'ci13000406': ['Leukemic infiltration of the peritoneum is a rare occurrence and can mimic peritoneal carcinomatosis in appearance (<xref ref-type="fig" rid="ci13000406">Fig. 6</xref>A–F). Its appearance on CT is non-specific and may demonstrate focal soft tissue masses or diffuse peritoneal infiltration with irregular thickening of the peritoneum and often ascitesA–F). Its appearance on CT is non-specific and may demonstrate focal soft tissue masses or diffuse peritoneal infiltration with irregular thickening of the peritoneum and often ascites[11,46]. The non-specific nature of these findings and the rarity of leukaemic recurrence in the peritoneum require the exclusion of a separate malignant process.\nFigure 6A 44-year-old man with a previous history of B-cell ALL. The patient had a complicated course after a successful bone marrow transplant. He developed obstructive hydrocephalous secondary to subarachnoid haemorrhage for which 2 ventriculoperitoneal shunts were placed. At the same presentation, his lumbar puncture demonstrated immature lymphocytes consistent with CNS recurrence of his ALL; this was successfully treated. Two years later, the patient represented with a palpable left upper quadrant mass. (a) Axial and (b0 coronal CT images demonstrate an irregular soft tissue mass in the left upper quadrant with diffuse mesenteric infiltration. (c) A hypoechoic soft tissue mass on ultrasonography, which on biopsy, proved to recurrent extramedullary B-cell ALL. Clinically, it was hypothesized that this peritoneal recurrence was iatrogenic, likely secondary to placement of the ventriculoperitoneal shunt. (d,e) A 26-year-old woman with previously treated AML. The patient represented with abdominal discomfort particularly in the pelvis and left upper quadrant. CT demonstrated a left upper quadrant mass and a second mass in the pelvis that was causing bilateral hydronephrosis. MRI of the pelvis demonstrated a well-defined heterogeneous mass within the pelvis that enhanced markedly after contrast. CT-guided biopsies of pelvic and right upper quadrant masses confirmed granulocytic sarcoma.'], 'ci13000407': ['The presentation of gastrointestinal recurrence is non-specific and can mimic graft-versus-host disease[47]. It can occur in the stomach, small bowel or colon (<xref ref-type="fig" rid="ci13000407">Fig. 7</xref>A,B). There are a variety of different findings within the gastrointestinal tract and infiltration can be mass-like, nodular, ulcerated, polypoid or plaque-likeA,B). There are a variety of different findings within the gastrointestinal tract and infiltration can be mass-like, nodular, ulcerated, polypoid or plaque-like[11,47,48]. Segmental bowel wall thickening occurs usually without stenosis and it is not possible to distinguish these on imaging alone from primary non-Hodgkin lymphoma or adenocarcinoma[10].\nFigure 7(a,b) A 28-year-old man in remission from B-cell ALL with clinically palpable supraclavicular lymph nodes. CT demonstrated a 12-cm length of proximal jejunum with tumour invasion, aneurysmal dilatation and without obstruction. The patient subsequently had an excellent response to chemotherapy.'], 'ci13000408': ['Involvement of the paranasal sinuses in recurrent extramedullary disease is uncommon (<xref ref-type="fig" rid="ci13000408">Fig. 8</xref>A,B). It can present with unilateral sinus symptoms or symptoms secondary to extension of the tumour into the adjacent orbits. CT findings typically show a soft tissue mass, which, in the presence of associated bony destruction or extension into adjacent cavities, is highly suspicious for diseaseA,B). It can present with unilateral sinus symptoms or symptoms secondary to extension of the tumour into the adjacent orbits. CT findings typically show a soft tissue mass, which, in the presence of associated bony destruction or extension into adjacent cavities, is highly suspicious for disease[49]. Differentials include malignant neoplasms such as squamous cell carcinoma, lymphoma and rhabdomyosarcoma, traumatic haematomas and benign polypoid lesions.\nFigure 8(a,b) A 41-year-old woman with a history of ALL found on clinical examination to have painless proptosis of the right eye. CT of the brain shows a sinus mass that has eroded through the lamina papyracea and cribriform plate. It is displacing the ocular muscles and optic nerve. Imaging of the orbits after intensive chemotherapy demonstrated complete resolution of the infiltrative lesion.'], 'ci13000409': ['Extramedullary recurrence of the skin is termed leukaemia cutis and occurs in approximately 3% of patients with AML; it has been rarely reported in ALL. It may occur in the epidermis, dermis or subcutis (<xref ref-type="fig" rid="ci13000409">Fig. 9</xref>))[22]. It can appear as ill-defined nodules or may be infiltrative in appearance[11,22]. It is most commonly found in the lower extremities; the upper extremities, the back and trunk are progressively less frequent sites of occurrence[22]. The differential for their appearance includes inflammatory, infectious and malignant conditions and the incidence may be overestimated as a result because biopsy is not always performed[11,22].\nFigure 9A 26-year-old woman with a previous history of AML whose treatment included bone marrow transplantation. Clinical examination showed a palpable abdominal mass. CT of the abdomen demonstrated a large subcutaneous deposit. Ultrasound-guided biopsy confirmed granulocytic sarcoma. A small second focus of increased attenuation in the left flank was also felt likely to represent a second focus of recurrence; this was not biopsied at the time, however.']} | Imaging findings in recurrent extramedullary leukaemias | [
"Extramedullary leukaemia",
"extramedullary relapse",
"computed tomography",
"magnetic resonance imaging",
"ultrasonography"
] | Cancer Imaging | 1361692800 | Since 2006, the National Institutes of Health has provided institutional infrastructure grants, called Clinical and Translational Science Awards (CTSAs), to support adult and pediatric clinical and translational research in United States institutions. A CTSA Consortium Child Health Oversight Committee workgroup developed metrics to measure the impact of CTSAs on child health (CH) research. A cross-sectional survey to collect metric data was distributed to the 46 institutions that received CTSAs during 2006-09. Thirty-seven (80%) institutions responded to the survey. Data regarding 7 metrics were reported by >70% of responding institutions: the proportion of overall funding (median, interquartile range; 0.12, 0.06–0.19) and pilot grants (0.15, 0.11–0.21) supporting CH research; the proportion of active clinical research center studies involving children (0.23, 0.15–0.35); the proportion of IRB-approved (0.24, 0.16–0.30) and funded (0.22, 0.18–0.30) studies involving children; the proportion of mentored research training awards to CH investigators (0.18, 0.11–0.28); and, the proportion of CTSA leadership positions held by pediatricians (0.18, 0.12–0.28). CTSAs provide substantial support for CH research, although additional investment in CH research is needed to improve the health of children. These metrics provide an initial means to track the impact of CTSAs on CH research. | [
"Awards and Prizes",
"Child",
"Child Welfare",
"Humans",
"National Institutes of Health (U.S.)",
"Program Development",
"Program Evaluation",
"Research",
"United States"
] | other | PMC3581869 | null | 15 | [
"{'Citation': 'Winer KK, Levin E, Grave GD, Alexander DF. The Child Health Research Centers program: 1990-2000. J Pediatr. 2001;139:757–8.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11743493'}}}",
"{'Citation': 'McCabe LL. National Institutes of Health support for research and training: future of pediatrician scientists. Arch Pediatr Adolesc Med. 1998;152:839–42.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9743027'}}}",
"{'Citation': 'Zerhouni EA. Translational and clinical science--time for a new vision. N Engl J Med. 2005;353:1621–3.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16221788'}}}",
"{'Citation': 'Zerhouni EA. US biomedical research: basic, translational, and clinical sciences. JAMA. 2005;294:1352–8.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16174693'}}}",
"{'Citation': 'Office of Legislative Policy and Analysis [21 April 2011];Legislative updates: National Institutes of Health Reform Act of 2006. http://olpa.od.nih.gov/legislation/109/publiclaws/reformact06.asp.'}",
"{'Citation': 'CTSA Consortium [29 November 2011];NCRR Fact Sheet: Clinical and Translational Science Awards. https://www.ctsacentral.org/documents/Communication_Toolkit/CTSA_FactSheet.pdf.'}",
"{'Citation': 'CTSA Consortium [29 November 2011];CTSA Consortium Child Health Oversight Committee. https://www.ctsacentral.org/committee/ctsa-consortium-child-health-oversight-committee.'}",
"{'Citation': 'Heubi JE. Child health research and the Clinical Translational Science Awards: where have we been and where are we going? Clin Transl Sci. 2010;3:67–68.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC5350707'}, {'@IdType': 'pubmed', '#text': '20590672'}]}}",
"{'Citation': 'Office of Extramural Research, National Insitutes of Health [14 May 14 2011];Glossary & acronym list. http://grants.nih.gov/grants/glossary.htm.'}",
"{'Citation': 'NIH Guide [14 May 2011];NIH policy and guideines on the inclusion of children as participants in research involving human subjects. http://grants.nih.gov/grants/guide/notice-files/not98-024.html.'}",
"{'Citation': 'Clinical and Translational Science Awards [29 November 2011];Strategic Goal Committees. https://www.ctsacentral.org/content/strategic-goal-committees.'}",
"{'Citation': 'Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2700030'}, {'@IdType': 'pubmed', '#text': '18929686'}]}}",
"{'Citation': 'Hay WW, Jr, Gitterman DP, Williams DA, Dover GJ, Sectish TC, Schleiss MR. Child health research funding and policy: imperatives and investments for a healthier world. Pediatrics. 2010;125:1259–65.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3857014'}, {'@IdType': 'pubmed', '#text': '20457684'}]}}",
"{'Citation': 'Genel M, McCaffree MA, Hendricks K, Dennery PA, Hay WW, Jr., Stanton B, et al. Pediatrics; A National Agenda for America’s Children and Adolescents in 2008: recommendations from the 15th Annual Public Policy Plenary Symposium, Annual Meeting of the Pediatric Academic Societies; May 3, 2008; 2008. pp. 843–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18829810'}}}",
"{'Citation': 'Szilagyi PG. Translational research and pediatrics. Acad Pediatr. 2009;9:71–80.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19329097'}}}"
] | Cancer Imaging. 2013 Feb 24; 13(1):26-35 | NO-CC CODE |
|
A 44-year-old man with a previous history of B-cell ALL. The patient had a complicated course after a successful bone marrow transplant. He developed obstructive hydrocephalous secondary to subarachnoid haemorrhage for which 2 ventriculoperitoneal shunts were placed. At the same presentation, his lumbar puncture demonstrated immature lymphocytes consistent with CNS recurrence of his ALL; this was successfully treated. Two years later, the patient represented with a palpable left upper quadrant mass. (a) Axial and (b0 coronal CT images demonstrate an irregular soft tissue mass in the left upper quadrant with diffuse mesenteric infiltration. (c) A hypoechoic soft tissue mass on ultrasonography, which on biopsy, proved to recurrent extramedullary B-cell ALL. Clinically, it was hypothesized that this peritoneal recurrence was iatrogenic, likely secondary to placement of the ventriculoperitoneal shunt. (d,e) A 26-year-old woman with previously treated AML. The patient represented with abdominal discomfort particularly in the pelvis and left upper quadrant. CT demonstrated a left upper quadrant mass and a second mass in the pelvis that was causing bilateral hydronephrosis. MRI of the pelvis demonstrated a well-defined heterogeneous mass within the pelvis that enhanced markedly after contrast. CT-guided biopsies of pelvic and right upper quadrant masses confirmed granulocytic sarcoma. | ci13000406 | 7 | 572fadcb6b507ea92c8b7eed9e41425755e7c9ddb04e3b6ba7883b5b9820d29b | ci13000406.jpg | multiple | multiple panels: images | [
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"computerized tomography"
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725,
938
] | [{'image_id': 'ci13000407', 'image_file_name': 'ci13000407.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000407.jpg', 'caption': '(a,b) A 28-year-old man in remission from B-cell ALL with clinically palpable supraclavicular lymph nodes. CT demonstrated a 12-cm length of proximal jejunum with tumour invasion, aneurysmal dilatation and without obstruction. The patient subsequently had an excellent response to chemotherapy.', 'hash': '6a7c6af00d55bace557a505189d15c0e79578166783b875695129e4c501a8ad8'}, {'image_id': 'ci13000409', 'image_file_name': 'ci13000409.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000409.jpg', 'caption': 'A 26-year-old woman with a previous history of AML whose treatment included bone marrow transplantation. Clinical examination showed a palpable abdominal mass. CT of the abdomen demonstrated a large subcutaneous deposit. Ultrasound-guided biopsy confirmed granulocytic sarcoma. A small second focus of increased attenuation in the left flank was also felt likely to represent a second focus of recurrence; this was not biopsied at the time, however.', 'hash': '3c75e1a5050d1854474ecad887b6dd8cefd6e42daf86ad692e35bcbefc98952e'}, {'image_id': 'ci13000408', 'image_file_name': 'ci13000408.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000408.jpg', 'caption': '(a,b) A 41-year-old woman with a history of ALL found on clinical examination to have painless proptosis of the right eye. CT of the brain shows a sinus mass that has eroded through the lamina papyracea and cribriform plate. It is displacing the ocular muscles and optic nerve. Imaging of the orbits after intensive chemotherapy demonstrated complete resolution of the infiltrative lesion.', 'hash': 'db0bda560ac49a4178f012a06c6025f3acdd970872d46a812d8db9990fccfc8b'}, {'image_id': 'ci13000406', 'image_file_name': 'ci13000406.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000406.jpg', 'caption': 'A 44-year-old man with a previous history of B-cell ALL. The patient had a complicated course after a successful bone marrow transplant. He developed obstructive hydrocephalous secondary to subarachnoid haemorrhage for which 2 ventriculoperitoneal shunts were placed. At the same presentation, his lumbar puncture demonstrated immature lymphocytes consistent with CNS recurrence of his ALL; this was successfully treated. Two years later, the patient represented with a palpable left upper quadrant mass. (a) Axial and (b0 coronal CT images demonstrate an irregular soft tissue mass in the left upper quadrant with diffuse mesenteric infiltration. (c) A hypoechoic soft tissue mass on ultrasonography, which on biopsy, proved to recurrent extramedullary B-cell ALL. Clinically, it was hypothesized that this peritoneal recurrence was iatrogenic, likely secondary to placement of the ventriculoperitoneal shunt. (d,e) A 26-year-old woman with previously treated AML. The patient represented with abdominal discomfort particularly in the pelvis and left upper quadrant. CT demonstrated a left upper quadrant mass and a second mass in the pelvis that was causing bilateral hydronephrosis. MRI of the pelvis demonstrated a well-defined heterogeneous mass within the pelvis that enhanced markedly after contrast. CT-guided biopsies of pelvic and right upper quadrant masses confirmed granulocytic sarcoma.', 'hash': '572fadcb6b507ea92c8b7eed9e41425755e7c9ddb04e3b6ba7883b5b9820d29b'}, {'image_id': 'ci13000401', 'image_file_name': 'ci13000401.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000401.jpg', 'caption': 'Basic treatment pathway.', 'hash': 'a26749363866b0b4d9d3413d3f1a6c9c88672c17e2a1bb46477b608ec13c5691'}, {'image_id': 'ci13000402', 'image_file_name': 'ci13000402.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000402.jpg', 'caption': '(a,b) A 25-year-old woman with previous AML after bone marrow transplant presented with left leg pain. Nerve conduction studies were consistent with left sciatic nerve compression. T2-weighted fat-saturated sequences demonstrate an elongated spindle-shaped enhancing soft tissue mass measuring 2\u2009×\u20092\u2009cm axially and extending 14\u2009cm craniocaudally in the flexor compartment of the thigh. The mass completely resolved after chemotherapy.', 'hash': 'bbe938cfa80d4fcbc07023589fbe71eadd41e3390c5a40d136b24c68727e50ec'}, {'image_id': 'ci13000405', 'image_file_name': 'ci13000405.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000405.jpg', 'caption': 'A 22-year-old man with a background of T-cell ALL presented with bilateral sudden loss of vision. CT showed bilateral nodular enhancing optic nerve lesions consistent with disease recurrence.', 'hash': 'c2d45c9a0b86a8dd25c2a7fdb40fd8b343d04b66bde20122eaf97e8e35809e2b'}, {'image_id': 'ci13000404', 'image_file_name': 'ci13000404.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000404.jpg', 'caption': 'A 28-year-old man with a previous history of ALL presented 2 years after diagnosis and chemotherapy with subtle induration of the left testicle on clinical examination. (a–c) Ultrasonography demonstrated extensive low attenuation lesions within both testes replacing approximately 50% of the right testicle and 75% of the left with significant associated increased vascularity within the abnormal areas. The findings are consistent with an extramedullary leukemic recurrence.', 'hash': 'bf616714db6de6cf2e5ac0e008dbfc77de21016e038a1e99a4c776d44c46207a'}, {'image_id': 'ci13000403', 'image_file_name': 'ci13000403.jpg', 'image_path': '../data/media_files/PMC3581869/ci13000403.jpg', 'caption': '(a) Breast ultrasonograph of a 41-year-old woman with a history of ALL found on clinical examination to have multiple palpable bilateral breast masses. The ultrasound image demonstrates a heterogeneous hypoechoic mass in the left breast. Similar masses were demonstrated in the right breast. (b) Mammogram on the same patient demonstrates lesions are isodense with surrounding breast parenchyma and not readily appreciable. Subsequent bilateral breast biopsy was positive for extramedullary recurrence of ALL. (c) Breast ultrasonograph of a 25-year-old woman with a previous history of AML. Clinical examination revealed a palpable mass in the left breast. Ultrasonography demonstrated a unilateral well-defined hypoechoic mass with posterior enhancement. Histology confirmed recurrent AML of the breast.', 'hash': 'eea0ae657bda9268e1cc19be2dfd82bad7a9a8c7d207ad7ed510f033d48de5bc'}] | {'ci13000401': ['Treatment of leukaemias consists of induction therapy and post-remission therapy. Complex multiple agent regimens are used with the aim of rapidly restoring bone marrow function, preventing the development of resistant cell lines and treating sanctuary sites such as the CNS as relapse is associated with a poor prognosis. Induction therapy should reduce the leukaemia cell population to below cytologically detectable levels. A substantial cytologically unmeasurable population can remain after initial therapy, which will lead to disease relapse and is countered with post-remission therapy. The choice of post-remission therapy is determined by the patients’ risk of relapse and involves consolidation chemotherapy, autologous and allogenic haematopoietic stem cell transplantation. Patients are categorized as low, intermediate or high risk of recurrence according to their clinical, cytological and cytogenetic profiles[24–31]. A simplified overview is demonstrated in <xref ref-type="fig" rid="ci13000401">Fig. 1</xref>.\n.\nFigure 1Basic treatment pathway.'], 'ci13000402': ['Peripheral nervous system (<xref ref-type="fig" rid="ci13000402">Fig. 2</xref>A,B) involvement in recurrent extramedullary disease is rarely reported in the literature. Documented presentations include mono- and polyneuropathies and small patient numbers mean that there are currently no definitive imaging findings for this group of patientsA,B) involvement in recurrent extramedullary disease is rarely reported in the literature. Documented presentations include mono- and polyneuropathies and small patient numbers mean that there are currently no definitive imaging findings for this group of patients[36–38].\nFigure 2(a,b) A 25-year-old woman with previous AML after bone marrow transplant presented with left leg pain. Nerve conduction studies were consistent with left sciatic nerve compression. T2-weighted fat-saturated sequences demonstrate an elongated spindle-shaped enhancing soft tissue mass measuring 2\u2009×\u20092\u2009cm axially and extending 14\u2009cm craniocaudally in the flexor compartment of the thigh. The mass completely resolved after chemotherapy.'], 'ci13000403': ['Leukaemic infiltrations of the breast (<xref ref-type="fig" rid="ci13000403">Fig. 3</xref>A–D) are reported to account for only 4% of metastatic deposits from primary extra-mammary malignancyA–D) are reported to account for only 4% of metastatic deposits from primary extra-mammary malignancy[39]. Mammographic appearance is non-specific, usually evident as asymmetry. Ultrasonographic findings consist of ill-defined shadows similar to invasive lobular carcinoma although in comparison with leukaemic masses, an echogenic margin can be seen[40]. Lesions are typically heterogeneous in appearance, with ill-defined margins. Acoustic shadowing may be present or absent[11,41]. Relapse of AML to the breast is more common than ALL, and those cases of ALL breast recurrence that do occur are most often bilateral[41]. Definitive differentiation from other breast lesions is difficult on imaging alone although a history of previous leukaemia should increase clinical suspicion for a possible unusual re-presentation.\nFigure 3(a) Breast ultrasonograph of a 41-year-old woman with a history of ALL found on clinical examination to have multiple palpable bilateral breast masses. The ultrasound image demonstrates a heterogeneous hypoechoic mass in the left breast. Similar masses were demonstrated in the right breast. (b) Mammogram on the same patient demonstrates lesions are isodense with surrounding breast parenchyma and not readily appreciable. Subsequent bilateral breast biopsy was positive for extramedullary recurrence of ALL. (c) Breast ultrasonograph of a 25-year-old woman with a previous history of AML. Clinical examination revealed a palpable mass in the left breast. Ultrasonography demonstrated a unilateral well-defined hypoechoic mass with posterior enhancement. Histology confirmed recurrent AML of the breast.'], 'ci13000404': ['The testicles, being a sanctuary site, are the most common location of extramedullary leukaemic recurrence in males (<xref ref-type="fig" rid="ci13000404">Fig. 4</xref>A–C). It occurs most commonly in the first 2–3 years of the primary disease although recurrence has been reported 19 years after initial diagnosis. In those with testicular recurrence, clinical assessment reveals bilateral involvement in 30% and histology shows bilateral involvement in 80%. Typical ultrasonographic appearances are of enlarged hypervascular testes. They may be of homogeneous echogenicity, especially when small, but often show diffuse or focal hypoechoic lesions replacing normal testicular tissueA–C). It occurs most commonly in the first 2–3 years of the primary disease although recurrence has been reported 19 years after initial diagnosis. In those with testicular recurrence, clinical assessment reveals bilateral involvement in 30% and histology shows bilateral involvement in 80%. Typical ultrasonographic appearances are of enlarged hypervascular testes. They may be of homogeneous echogenicity, especially when small, but often show diffuse or focal hypoechoic lesions replacing normal testicular tissue[11,42,43]. A clinical history of previous leukaemia should raise high clinical suspicion for recurrence, although sonographic appearances can also include differentials of seminomatous tumours, orchitis and testicular abscess[44].\nFigure 4A 28-year-old man with a previous history of ALL presented 2 years after diagnosis and chemotherapy with subtle induration of the left testicle on clinical examination. (a–c) Ultrasonography demonstrated extensive low attenuation lesions within both testes replacing approximately 50% of the right testicle and 75% of the left with significant associated increased vascularity within the abnormal areas. The findings are consistent with an extramedullary leukemic recurrence.'], 'ci13000405': ['Orbital involvement of relapsed disease is common and often presents as painless proptosis (<xref ref-type="fig" rid="ci13000405">Fig. 5</xref>). It is usually identified as a homogeneous mass, may be bilateral and can involve bony erosion, most often of the medial orbital wall. It may also arise outside the orbit and invade into it from the adjacent structures). It is usually identified as a homogeneous mass, may be bilateral and can involve bony erosion, most often of the medial orbital wall. It may also arise outside the orbit and invade into it from the adjacent structures[32,43,45].\nFigure 5A 22-year-old man with a background of T-cell ALL presented with bilateral sudden loss of vision. CT showed bilateral nodular enhancing optic nerve lesions consistent with disease recurrence.'], 'ci13000406': ['Leukemic infiltration of the peritoneum is a rare occurrence and can mimic peritoneal carcinomatosis in appearance (<xref ref-type="fig" rid="ci13000406">Fig. 6</xref>A–F). Its appearance on CT is non-specific and may demonstrate focal soft tissue masses or diffuse peritoneal infiltration with irregular thickening of the peritoneum and often ascitesA–F). Its appearance on CT is non-specific and may demonstrate focal soft tissue masses or diffuse peritoneal infiltration with irregular thickening of the peritoneum and often ascites[11,46]. The non-specific nature of these findings and the rarity of leukaemic recurrence in the peritoneum require the exclusion of a separate malignant process.\nFigure 6A 44-year-old man with a previous history of B-cell ALL. The patient had a complicated course after a successful bone marrow transplant. He developed obstructive hydrocephalous secondary to subarachnoid haemorrhage for which 2 ventriculoperitoneal shunts were placed. At the same presentation, his lumbar puncture demonstrated immature lymphocytes consistent with CNS recurrence of his ALL; this was successfully treated. Two years later, the patient represented with a palpable left upper quadrant mass. (a) Axial and (b0 coronal CT images demonstrate an irregular soft tissue mass in the left upper quadrant with diffuse mesenteric infiltration. (c) A hypoechoic soft tissue mass on ultrasonography, which on biopsy, proved to recurrent extramedullary B-cell ALL. Clinically, it was hypothesized that this peritoneal recurrence was iatrogenic, likely secondary to placement of the ventriculoperitoneal shunt. (d,e) A 26-year-old woman with previously treated AML. The patient represented with abdominal discomfort particularly in the pelvis and left upper quadrant. CT demonstrated a left upper quadrant mass and a second mass in the pelvis that was causing bilateral hydronephrosis. MRI of the pelvis demonstrated a well-defined heterogeneous mass within the pelvis that enhanced markedly after contrast. CT-guided biopsies of pelvic and right upper quadrant masses confirmed granulocytic sarcoma.'], 'ci13000407': ['The presentation of gastrointestinal recurrence is non-specific and can mimic graft-versus-host disease[47]. It can occur in the stomach, small bowel or colon (<xref ref-type="fig" rid="ci13000407">Fig. 7</xref>A,B). There are a variety of different findings within the gastrointestinal tract and infiltration can be mass-like, nodular, ulcerated, polypoid or plaque-likeA,B). There are a variety of different findings within the gastrointestinal tract and infiltration can be mass-like, nodular, ulcerated, polypoid or plaque-like[11,47,48]. Segmental bowel wall thickening occurs usually without stenosis and it is not possible to distinguish these on imaging alone from primary non-Hodgkin lymphoma or adenocarcinoma[10].\nFigure 7(a,b) A 28-year-old man in remission from B-cell ALL with clinically palpable supraclavicular lymph nodes. CT demonstrated a 12-cm length of proximal jejunum with tumour invasion, aneurysmal dilatation and without obstruction. The patient subsequently had an excellent response to chemotherapy.'], 'ci13000408': ['Involvement of the paranasal sinuses in recurrent extramedullary disease is uncommon (<xref ref-type="fig" rid="ci13000408">Fig. 8</xref>A,B). It can present with unilateral sinus symptoms or symptoms secondary to extension of the tumour into the adjacent orbits. CT findings typically show a soft tissue mass, which, in the presence of associated bony destruction or extension into adjacent cavities, is highly suspicious for diseaseA,B). It can present with unilateral sinus symptoms or symptoms secondary to extension of the tumour into the adjacent orbits. CT findings typically show a soft tissue mass, which, in the presence of associated bony destruction or extension into adjacent cavities, is highly suspicious for disease[49]. Differentials include malignant neoplasms such as squamous cell carcinoma, lymphoma and rhabdomyosarcoma, traumatic haematomas and benign polypoid lesions.\nFigure 8(a,b) A 41-year-old woman with a history of ALL found on clinical examination to have painless proptosis of the right eye. CT of the brain shows a sinus mass that has eroded through the lamina papyracea and cribriform plate. It is displacing the ocular muscles and optic nerve. Imaging of the orbits after intensive chemotherapy demonstrated complete resolution of the infiltrative lesion.'], 'ci13000409': ['Extramedullary recurrence of the skin is termed leukaemia cutis and occurs in approximately 3% of patients with AML; it has been rarely reported in ALL. It may occur in the epidermis, dermis or subcutis (<xref ref-type="fig" rid="ci13000409">Fig. 9</xref>))[22]. It can appear as ill-defined nodules or may be infiltrative in appearance[11,22]. It is most commonly found in the lower extremities; the upper extremities, the back and trunk are progressively less frequent sites of occurrence[22]. The differential for their appearance includes inflammatory, infectious and malignant conditions and the incidence may be overestimated as a result because biopsy is not always performed[11,22].\nFigure 9A 26-year-old woman with a previous history of AML whose treatment included bone marrow transplantation. Clinical examination showed a palpable abdominal mass. CT of the abdomen demonstrated a large subcutaneous deposit. Ultrasound-guided biopsy confirmed granulocytic sarcoma. A small second focus of increased attenuation in the left flank was also felt likely to represent a second focus of recurrence; this was not biopsied at the time, however.']} | Imaging findings in recurrent extramedullary leukaemias | [
"Extramedullary leukaemia",
"extramedullary relapse",
"computed tomography",
"magnetic resonance imaging",
"ultrasonography"
] | Cancer Imaging | 1361692800 | Since 2006, the National Institutes of Health has provided institutional infrastructure grants, called Clinical and Translational Science Awards (CTSAs), to support adult and pediatric clinical and translational research in United States institutions. A CTSA Consortium Child Health Oversight Committee workgroup developed metrics to measure the impact of CTSAs on child health (CH) research. A cross-sectional survey to collect metric data was distributed to the 46 institutions that received CTSAs during 2006-09. Thirty-seven (80%) institutions responded to the survey. Data regarding 7 metrics were reported by >70% of responding institutions: the proportion of overall funding (median, interquartile range; 0.12, 0.06–0.19) and pilot grants (0.15, 0.11–0.21) supporting CH research; the proportion of active clinical research center studies involving children (0.23, 0.15–0.35); the proportion of IRB-approved (0.24, 0.16–0.30) and funded (0.22, 0.18–0.30) studies involving children; the proportion of mentored research training awards to CH investigators (0.18, 0.11–0.28); and, the proportion of CTSA leadership positions held by pediatricians (0.18, 0.12–0.28). CTSAs provide substantial support for CH research, although additional investment in CH research is needed to improve the health of children. These metrics provide an initial means to track the impact of CTSAs on CH research. | [
"Awards and Prizes",
"Child",
"Child Welfare",
"Humans",
"National Institutes of Health (U.S.)",
"Program Development",
"Program Evaluation",
"Research",
"United States"
] | other | PMC3581869 | null | 15 | [
"{'Citation': 'Winer KK, Levin E, Grave GD, Alexander DF. The Child Health Research Centers program: 1990-2000. J Pediatr. 2001;139:757–8.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11743493'}}}",
"{'Citation': 'McCabe LL. National Institutes of Health support for research and training: future of pediatrician scientists. Arch Pediatr Adolesc Med. 1998;152:839–42.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9743027'}}}",
"{'Citation': 'Zerhouni EA. Translational and clinical science--time for a new vision. N Engl J Med. 2005;353:1621–3.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16221788'}}}",
"{'Citation': 'Zerhouni EA. US biomedical research: basic, translational, and clinical sciences. JAMA. 2005;294:1352–8.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16174693'}}}",
"{'Citation': 'Office of Legislative Policy and Analysis [21 April 2011];Legislative updates: National Institutes of Health Reform Act of 2006. http://olpa.od.nih.gov/legislation/109/publiclaws/reformact06.asp.'}",
"{'Citation': 'CTSA Consortium [29 November 2011];NCRR Fact Sheet: Clinical and Translational Science Awards. https://www.ctsacentral.org/documents/Communication_Toolkit/CTSA_FactSheet.pdf.'}",
"{'Citation': 'CTSA Consortium [29 November 2011];CTSA Consortium Child Health Oversight Committee. https://www.ctsacentral.org/committee/ctsa-consortium-child-health-oversight-committee.'}",
"{'Citation': 'Heubi JE. Child health research and the Clinical Translational Science Awards: where have we been and where are we going? Clin Transl Sci. 2010;3:67–68.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC5350707'}, {'@IdType': 'pubmed', '#text': '20590672'}]}}",
"{'Citation': 'Office of Extramural Research, National Insitutes of Health [14 May 14 2011];Glossary & acronym list. http://grants.nih.gov/grants/glossary.htm.'}",
"{'Citation': 'NIH Guide [14 May 2011];NIH policy and guideines on the inclusion of children as participants in research involving human subjects. http://grants.nih.gov/grants/guide/notice-files/not98-024.html.'}",
"{'Citation': 'Clinical and Translational Science Awards [29 November 2011];Strategic Goal Committees. https://www.ctsacentral.org/content/strategic-goal-committees.'}",
"{'Citation': 'Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2700030'}, {'@IdType': 'pubmed', '#text': '18929686'}]}}",
"{'Citation': 'Hay WW, Jr, Gitterman DP, Williams DA, Dover GJ, Sectish TC, Schleiss MR. Child health research funding and policy: imperatives and investments for a healthier world. Pediatrics. 2010;125:1259–65.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3857014'}, {'@IdType': 'pubmed', '#text': '20457684'}]}}",
"{'Citation': 'Genel M, McCaffree MA, Hendricks K, Dennery PA, Hay WW, Jr., Stanton B, et al. Pediatrics; A National Agenda for America’s Children and Adolescents in 2008: recommendations from the 15th Annual Public Policy Plenary Symposium, Annual Meeting of the Pediatric Academic Societies; May 3, 2008; 2008. pp. 843–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18829810'}}}",
"{'Citation': 'Szilagyi PG. Translational research and pediatrics. Acad Pediatr. 2009;9:71–80.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19329097'}}}"
] | Cancer Imaging. 2013 Feb 24; 13(1):26-35 | NO-CC CODE |
|
MR Image through common femoral region showing an inhomogenous predominantly low T1 signal mass in the region of the common femoral artery. | umj7703-203-f1 | 7 | fa3992c08b4a00b40bfe2d9199b7e0d707dc8e6c10a7cb1d8b15f867ce022be6 | umj7703-203-f1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
427,
224
] | [{'image_id': 'umj7703-203-f1', 'image_file_name': 'umj7703-203-f1.jpg', 'image_path': '../data/media_files/PMC2604479/umj7703-203-f1.jpg', 'caption': 'MR Image through common femoral region showing an inhomogenous predominantly low T1 signal mass in the region of the common femoral artery.', 'hash': 'fa3992c08b4a00b40bfe2d9199b7e0d707dc8e6c10a7cb1d8b15f867ce022be6'}, {'image_id': 'umj7703-203-f2', 'image_file_name': 'umj7703-203-f2.jpg', 'image_path': '../data/media_files/PMC2604479/umj7703-203-f2.jpg', 'caption': 'Image showing debrided groin wound with Rectus femoris flap placed over the graft.', 'hash': 'd89335ccc17f75a12a5545e4c251f31e7989e6d2172fd92ca06217b18777ee71'}, {'image_id': 'umj7703-203-f3', 'image_file_name': 'umj7703-203-f3.jpg', 'image_path': '../data/media_files/PMC2604479/umj7703-203-f3.jpg', 'caption': 'Image of the healing groin wound showing survival of the limb.', 'hash': '443e3a79fd953475362943e895f2899b2f344939227984eb56df9737de09e0f1'}] | {'umj7703-203-f1': ['A diagnosis of an infected inguinal haematoma was made. The patient was commenced on prophylactic low molecular weight Heparin subcutaneously and given Metronidazole, Ciprofloxacin, and Benzylpenicillin intravenously. A Magnetic Resonance Angiogram showed a large collection with gas formation in the anterior and medial compartments of the thigh causing bowstringing of the femoral vessels (<xref ref-type="fig" rid="umj7703-203-f1">Figure 1</xref>). Evacuation of a putrefied haematoma was undertaken.). Evacuation of a putrefied haematoma was undertaken.'], 'umj7703-203-f2': ['In the next four days the patient required antero-lateral and postero-medial fasciotomies of the leg, further debridement of the groin wound, and a rectus femoris muscle flap mobilised and placed over the graft (<xref ref-type="fig" rid="umj7703-203-f2">Fig 2</xref>). Six days after the original procedure, torrential bleeding required ligation of the proximal common femoral artery. At seven weeks the limb remains viable (). Six days after the original procedure, torrential bleeding required ligation of the proximal common femoral artery. At seven weeks the limb remains viable (<xref ref-type="fig" rid="umj7703-203-f3">Fig 3</xref>) with rapid secondary healing of the groin wound and fasciotomies, using a closure (V.A.C.®) device.) with rapid secondary healing of the groin wound and fasciotomies, using a closure (V.A.C.®) device.']} | Femoral artery necrosis due to parenteral intravascular drug misuse: A case report and literature review | [
"Femoral artery necrosis",
"Intravenous drug abuse",
"Intra-arterial injection"
] | Ulster Med J | 1220252400 | None | null | other | PMC2604479 | null | null | [
""
] | Ulster Med J. 2008 Sep; 77(3):203-204 | NO-CC CODE |
|
Chest CT performed at 15 months old, 9 months after discharge. Coronal reformatted image shows reduction of dilated and collapsed segments of bronchial tree and patchy ground-glass appearance in both lungs | 247_2022_5398_Fig6_HTML | 7 | 01e4b09acbe2bca139d932e5770535ef6292678d109089779859df4415361a76 | 247_2022_5398_Fig6_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
644,
541
] | [{'image_id': '247_2022_5398_Fig4_HTML', 'image_file_name': '247_2022_5398_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC9127284/247_2022_5398_Fig4_HTML.jpg', 'caption': 'Chest CT was performed at 5\xa0months old, on the 13th day after shunt surgery. a–c Axial chest CT images passing through the upper lung zone (a) and through the middle and lower lung zones (b) and coronal reformatted image (c) show bronchial dilatation in all lobes of both lungs (arrows)', 'hash': '1909eb668b82ec85903f7f421e62519d83f4190bb494b8729fdbd1b9b900aab3'}, {'image_id': '247_2022_5398_Fig3_HTML', 'image_file_name': '247_2022_5398_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC9127284/247_2022_5398_Fig3_HTML.jpg', 'caption': 'Post-surgery radiography. a Anteroposterior chest radiograph of the girl at 5\xa0months old, obtained 2\xa0days after shunt surgery, shows parenchymal consolidation in the lower zone of the right lung and ground-glass infiltrates in the upper and lower zones of the left lung. Nasal aspirate was positive for influenza virus. b Control chest radiograph taken 8\xa0days later shows resolving of the infiltrates in both lungs, as well as suspicion of bronchiectasis in the left lung (arrows)', 'hash': '765b6be993433e2c314dabf773b3aad1e526eef13235742579da06a6bfb41175'}, {'image_id': '247_2022_5398_Fig5_HTML', 'image_file_name': '247_2022_5398_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC9127284/247_2022_5398_Fig5_HTML.jpg', 'caption': 'Cardiac total repair operation was performed 20\xa0days after the first shunt surgery. This chest CT was obtained at 6\xa0months old, on the 20th day after the total repair operation. a, b Coronal reformatted (a) and anterior view three-dimensional (3-D) volume rendered (b) chest CT images show progression of bronchial dilatation (white arrows) and narrow segments between them in both lungs “like a bunch of grapes” mimicking Williams–Campbell syndrome. There is also pig bronchus anomaly originating from the trachea (a, black arrow)', 'hash': '4088d5acd1ad69cea670d62e313a3b5e96036029a39cac4c143c2e611a409730'}, {'image_id': '247_2022_5398_Fig2_HTML', 'image_file_name': '247_2022_5398_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC9127284/247_2022_5398_Fig2_HTML.jpg', 'caption': 'Pre-surgery radiography. Anteroposterior chest radiograph of the girl at 5\xa0months old, obtained on the second day of admission before the shunt surgery, shows normal findings', 'hash': '0a43663b4ac1768edc040ef0777a7a171369212c94d2fc4aa0ee1ffac2cd716f'}, {'image_id': '247_2022_5398_Fig1_HTML', 'image_file_name': '247_2022_5398_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC9127284/247_2022_5398_Fig1_HTML.jpg', 'caption': 'Diagram shows the girl’s family history of chronic obstructive airway disease and sensorineural hearing loss. The arrow indicates the patient', 'hash': '0f854bb1910c059e58f21061e816efd36210cbfbb03d521830877a7896936c5b'}, {'image_id': '247_2022_5398_Fig6_HTML', 'image_file_name': '247_2022_5398_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC9127284/247_2022_5398_Fig6_HTML.jpg', 'caption': 'Chest CT performed at 15\xa0months old, 9\xa0months after discharge. Coronal reformatted image shows reduction of dilated and collapsed segments of bronchial tree and patchy ground-glass appearance in both lungs', 'hash': '01e4b09acbe2bca139d932e5770535ef6292678d109089779859df4415361a76'}] | {'247_2022_5398_Fig1_HTML': ['A 7-day-old girl was referred to our hospital with suspicion of a congenital heart disease because of cyanosis during feeding and strong murmur on physical examination. She was born by caesarian section to non-consanguineous parents at 32\xa0weeks of gestation because a placental tumor reached about 2\xa0cm and impaired the perfusion. Fetal US showed no abnormality except one umbilical artery and vein, and other screening tests were normal. She gradually became sick and had poor weight gain postnatally. Family history involved several relatives who had chronic obstructive pulmonary disease and sensorineural hearing loss (Fig.\xa0<xref rid="247_2022_5398_Fig1_HTML" ref-type="fig">1</xref>). On physical examination, her weight and height were both 2 standard deviations below normal for age. She had a 2/6 pansystolic murmur and mild cyanosis. Her chest radiograph was normal (Fig.\xa0). On physical examination, her weight and height were both 2 standard deviations below normal for age. She had a 2/6 pansystolic murmur and mild cyanosis. Her chest radiograph was normal (Fig.\xa0<xref rid="247_2022_5398_Fig2_HTML" ref-type="fig">2</xref>). Echocardiography and cardiac catheterization showed a right-sided aortic arch, double outlet right ventricle, a large ventricular septal defect and pulmonary infundibular stenosis.). Echocardiography and cardiac catheterization showed a right-sided aortic arch, double outlet right ventricle, a large ventricular septal defect and pulmonary infundibular stenosis.Fig. 1Diagram shows the girl’s family history of chronic obstructive airway disease and sensorineural hearing loss. The arrow indicates the patientFig. 2Pre-surgery radiography. Anteroposterior chest radiograph of the girl at 5\xa0months old, obtained on the second day of admission before the shunt surgery, shows normal findings'], '247_2022_5398_Fig3_HTML': ['Despite beta blocker treatment, she had frequent cyanotic spells and modified Blalock–Taussig shunt was performed when she was 5\xa0months old. She was extubated 22\xa0h after surgery but was reintubated 21\xa0h after extubation because of gradually worsening respiratory distress. Meanwhile, chest radiograph showed new parenchymal infiltrates (Fig.\xa0<xref rid="247_2022_5398_Fig3_HTML" ref-type="fig">3</xref>) and nasal aspirate was positive for influenza B virus. She had severe and persistent hypoxia requiring high pressures on conventional ventilation; thus, we started high-frequency oscillatory ventilation. Eight days later, a chest radiograph showed improvement of infiltrates in both lungs, as well as suspicion of bronchiectasis in the left lung (Fig. ) and nasal aspirate was positive for influenza B virus. She had severe and persistent hypoxia requiring high pressures on conventional ventilation; thus, we started high-frequency oscillatory ventilation. Eight days later, a chest radiograph showed improvement of infiltrates in both lungs, as well as suspicion of bronchiectasis in the left lung (Fig. <xref rid="247_2022_5398_Fig3_HTML" ref-type="fig">3</xref>). She was mechanically ventilated for 43\xa0days overall with high-frequency oscillatory ventilation and synchronized intermittent mandatory ventilation modes for 20\xa0days and 23\xa0days, respectively. During this time, due to repeated extubation failures, chest CT angiography was performed. CT revealed known cardiovascular anomalies with patent Blalock–Taussig shunt. In addition, bronchial dilatation was detected in both lungs (Fig.\xa0). She was mechanically ventilated for 43\xa0days overall with high-frequency oscillatory ventilation and synchronized intermittent mandatory ventilation modes for 20\xa0days and 23\xa0days, respectively. During this time, due to repeated extubation failures, chest CT angiography was performed. CT revealed known cardiovascular anomalies with patent Blalock–Taussig shunt. In addition, bronchial dilatation was detected in both lungs (Fig.\xa0<xref rid="247_2022_5398_Fig4_HTML" ref-type="fig">4</xref>).).Fig. 3Post-surgery radiography. a Anteroposterior chest radiograph of the girl at 5\xa0months old, obtained 2\xa0days after shunt surgery, shows parenchymal consolidation in the lower zone of the right lung and ground-glass infiltrates in the upper and lower zones of the left lung. Nasal aspirate was positive for influenza virus. b Control chest radiograph taken 8\xa0days later shows resolving of the infiltrates in both lungs, as well as suspicion of bronchiectasis in the left lung (arrows)Fig. 4Chest CT was performed at 5\xa0months old, on the 13th day after shunt surgery. a–c Axial chest CT images passing through the upper lung zone (a) and through the middle and lower lung zones (b) and coronal reformatted image (c) show bronchial dilatation in all lobes of both lungs (arrows)'], '247_2022_5398_Fig5_HTML': ['A second operation was performed for total repair to decrease the pulmonary blood flow. After surgery, she was supported with veno-arterial ECMO for 6\xa0days, due to low cardiac output syndrome and acute respiratory distress syndrome (ARDS). After ECMO decannulation, the need for ventilatory pressures decreased remarkably but she still could not be extubated. Control chest CT was performed because of the failure of extubation, and progressive dilated and collapsed segments were observed in the bronchial tree of both lungs in comparison to previous CT, mimicking Williams–Campbell syndrome (Fig.\xa0<xref rid="247_2022_5398_Fig5_HTML" ref-type="fig">5</xref>). Conventional flexible bronchoscopy demonstrated severe tracheobronchomalacia. Although she was intubated, to show normal ciliary functions and rule out primary ciliary dyskinesia, a nasal ciliary function test was performed and found to be impaired. We decided to repeat the test under more appropriate conditions and suggested a genetic test to her family. CT scans of the affected relatives showed no typical findings of Williams–Campbell syndrome. Because of extubation failure she was discharged with a home-type ventilator attached via tracheostomy. She gradually gained weight and was weaned from the ventilator over 9\xa0months. After 9\xa0months, chest CT showed reduction of the bronchiectasis and re-expansion of the collapsed segments of the bronchial tree in both lungs (Fig.\xa0). Conventional flexible bronchoscopy demonstrated severe tracheobronchomalacia. Although she was intubated, to show normal ciliary functions and rule out primary ciliary dyskinesia, a nasal ciliary function test was performed and found to be impaired. We decided to repeat the test under more appropriate conditions and suggested a genetic test to her family. CT scans of the affected relatives showed no typical findings of Williams–Campbell syndrome. Because of extubation failure she was discharged with a home-type ventilator attached via tracheostomy. She gradually gained weight and was weaned from the ventilator over 9\xa0months. After 9\xa0months, chest CT showed reduction of the bronchiectasis and re-expansion of the collapsed segments of the bronchial tree in both lungs (Fig.\xa0<xref rid="247_2022_5398_Fig6_HTML" ref-type="fig">6</xref>).).Fig. 5Cardiac total repair operation was performed 20\xa0days after the first shunt surgery. This chest CT was obtained at 6\xa0months old, on the 20th day after the total repair operation. a, b Coronal reformatted (a) and anterior view three-dimensional (3-D) volume rendered (b) chest CT images show progression of bronchial dilatation (white arrows) and narrow segments between them in both lungs “like a bunch of grapes” mimicking Williams–Campbell syndrome. There is also pig bronchus anomaly originating from the trachea (a, black arrow)Fig. 6Chest CT performed at 15\xa0months old, 9\xa0months after discharge. Coronal reformatted image shows reduction of dilated and collapsed segments of bronchial tree and patchy ground-glass appearance in both lungs']} | Reversible bronchiectasis caused by influenza virus mimicking Williams–Campbell syndrome | [
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] | Pediatr Radiol | 1653375600 | The impact of the Covid-19 pandemic on international trade varies along several dimensions, including the type of product, the size of firm and over time. In this note, I provide evidence of systematic variation in the trade response to the pandemic along another, previously unexplored dimension, the mode of transportation. Analyzing daily data from New Zealand, I find that the value of seaborne exports and imports increases relative to shipments by air during pandemic lockdowns. While this finding is consistent with many explanations, including the sensitivity of trade to external finance, it generally provides support for the importance of frictions on the supply side. | [] | other | PMC9127284 | null | 7 | [
"{'Citation': 'Ahn JaeBin, Amiti Mary, Weinstein David\\xa0E. Trade finance and the great trade collapse. Amer. Econ. Rev. 2011;101:298–302.'}",
"{'Citation': 'Bems Rudolfs, Johnson Robert\\xa0C., Yi Kei-Mu. The great trade collapse. Annu. Rev. Econ. 2013;5:375–400.'}",
"{'Citation': 'Benguria Felipe. The 2020 trade collapse: Exporters amid the pandemic. Econom. Lett. 2021;205'}",
"{'Citation': 'Bricongne Jean-Charles, Carluccio Juan, Fontagné Lionel, Gaulier Guillaume, Stumpner Sebastian. From macro to micro: Heterogeneous exporters in the pandemic. Banque de France. 2021'}",
"{'Citation': 'Goldbach Stefan, Nitsch Volker. Covid-19 and capital flows: The responses of investors to the responses of governments. Open Econ. Rev. 2022 (forthcoming)'}",
"{'Citation': 'International Air Transport Association . 2021. IATA Annual Review 2021. https://www.iata.org/en/publications/annual-review/'}",
"{'Citation': 'World Trade Organization . 2020. Press release. available at https://www.wto.org/english/news_e/news20_e/stat_23sep20_e.htm.'}"
] | Pediatr Radiol. 2022 May 24; 52(13):2640-2644 | NO-CC CODE |
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Sagittal intermediate-weighted magnetic resonance image of a patient after osteochondral allograft (OCA) transplantation in the femoral trochlea (arrow). OCA cartilage signal, “fill,” and surface congruity are normal compared with adjacent host cartilage. Subchondral bone plate is incongruent and subchondral bone marrow signal is abnormal, but the host-graft junction demonstrates some osseous incorporation. | 10.1177_1947603515573987-fig1 | 7 | 3519ed8ba5c5ab647b2e895cb5a2232b8fbe65549581741c887e2af292db6d35 | 10.1177_1947603515573987-fig1.jpg | multiple | multiple panels: images | [
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"{'Citation': 'World Health Organization. Human infection with influenza A(H7N9) virus in China, 2013. \\nAvailable at: http://www.who.int/csr/don/2013_04_01/en/index.html\\nAccessed 5 September 2013.'}",
"{'Citation': 'World Health Organization. Human infection with avian influenza A(H7N9) virus—update, 2013. \\nAvailable at: http://www.who.int/csr/don/2013_08_11/en/index.html\\nAccessed 5 September 2013.'}",
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"{'Citation': 'Reed C, Biggerstaff M, Finelli L, et al. Novel framework for assessing epidemiologic effects of influenza epidemics and pandemics. Emerg Infect Dis 2013; 19:85–91.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3557974'}, {'@IdType': 'pubmed', '#text': '23260039'}]}}",
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"{'Citation': 'Meltzer MI, Patel A, Ajao A, Nystrom SV, Koonin LM. Estimates of the demand for mechanical ventilation in the United States during an influenza pandemic. Clin Infect Dis 2015; 60(suppl 1):S52–7.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4603361'}, {'@IdType': 'pubmed', '#text': '25878301'}]}}",
"{'Citation': 'Biggerstaff M, Reed C, Swerdlow DL, et al. Estimating the potential effects of a vaccine program against an emerging influenza pandemic—United States. Clin Infect Dis 2015; 60(suppl 1):S20–9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4610126'}, {'@IdType': 'pubmed', '#text': '25878298'}]}}",
"{'Citation': 'Mossong J, Hens N, Jit M, et al. Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Med 2008; 5:e74.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2270306'}, {'@IdType': 'pubmed', '#text': '18366252'}]}}",
"{'Citation': 'Markel H, Lipman HB, Navarro JA, et al. Nonpharmaceutical interventions implemented by US cities during the 1918–1919 influenza pandemic. JAMA 2007; 298:644–54.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17684187'}}}",
"{'Citation': 'Epidemiology Branch. The epidemiology of Asian influenza. 1957–1960. A descriptive brochure. Atlanta, Georgia: Communicable Disease Center, 1960.'}",
"{'Citation': 'Sharrar RG. National influenza experience in the U.S., 1968–1969. Bull World Health Org 1969; 41:361–6.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2427724'}, {'@IdType': 'pubmed', '#text': '5309440'}]}}",
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Sagittal intermediate-weighted magnetic resonance image of a patient after osteochondral allograft (OCA) transplantation in the medial femoral condyle (arrow). OCA cartilage signal, “fill,” and surface congruity are normal compared with adjacent host cartilage. Subchondral bone plate is incongruent, but subchondral bone marrow signal is preserved and the host-graft junction demonstrates some osseous incorporation. | 10.1177_1947603515573987-fig2 | 7 | d0d4ab4d091eaa154fb72943e648664396ef5883c6127cc587a6cfc49a196a39 | 10.1177_1947603515573987-fig2.jpg | multiple | multiple panels: images | [
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"{'Citation': 'World Health Organization. Human infection with avian influenza A(H7N9) virus—update, 2013. \\nAvailable at: http://www.who.int/csr/don/2013_08_11/en/index.html\\nAccessed 5 September 2013.'}",
"{'Citation': 'Li Q, Zhou L, Zhou M, et al. Epidemiology of human infections with avian influenza A(H7N9) virus in China. N Engl J Med 2014; 370:520–32.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC6652192'}, {'@IdType': 'pubmed', '#text': '23614499'}]}}",
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"{'Citation': 'Mossong J, Hens N, Jit M, et al. Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Med 2008; 5:e74.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2270306'}, {'@IdType': 'pubmed', '#text': '18366252'}]}}",
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"{'Citation': 'Epidemiology Branch. The epidemiology of Asian influenza. 1957–1960. A descriptive brochure. Atlanta, Georgia: Communicable Disease Center, 1960.'}",
"{'Citation': 'Sharrar RG. National influenza experience in the U.S., 1968–1969. Bull World Health Org 1969; 41:361–6.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2427724'}, {'@IdType': 'pubmed', '#text': '5309440'}]}}",
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] | Cartilage. 2015 Jul; 6(3):142-149 | NO-CC CODE |
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Axial chest CT scan following intravenous contrast material administration in the lower lungs of a 30-year-old male former smoker with a history of asthma who presented with fever, cough, and left lower back pain 3 weeks after symptom onset. CT demonstrates extensive dense patchy consolidation with relative subpleural sparing, most severe in the lung bases. Throughout the patient’s hospital course, he required supplemental oxygen via a nonrebreather mask and was noted to have elevated inflammatory markers, including C-reactive protein and interleukin-6. The patient was confirmed to be positive for coronavirus disease 2019 with polymerase chain reaction testing. | ryct.2020200210.fig5 | 7 | 2f824b55216e4eb78261ecfb56fa3f0a26208a7367c40ec34a8a5caa02cac346 | ryct.2020200210.fig5.jpg | multiple | multiple panels: images | [
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422
] | [{'image_id': 'ryct.2020200210.tbl1', 'image_file_name': 'ryct.2020200210.tbl1.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.tbl1.jpg', 'caption': 'Pulmonary Features of Various Imaging Modalities and Selected Studies', 'hash': '16a43f27332030945d39cda83ae81468507ce40d23c7736c52835adf63aaf5d8'}, {'image_id': 'ryct.2020200210.fig5', 'image_file_name': 'ryct.2020200210.fig5.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig5.jpg', 'caption': 'Axial chest CT scan following intravenous contrast material administration in the lower lungs of a 30-year-old male former smoker with a history of asthma who presented with fever, cough, and left lower back pain 3 weeks after symptom onset. CT demonstrates extensive dense patchy consolidation with relative subpleural sparing, most severe in the lung bases. Throughout the patient’s hospital course, he required supplemental oxygen via a nonrebreather mask and was noted to have elevated inflammatory markers, including C-reactive protein and interleukin-6. The patient was confirmed to be positive for coronavirus disease 2019 with polymerase chain reaction testing.', 'hash': '2f824b55216e4eb78261ecfb56fa3f0a26208a7367c40ec34a8a5caa02cac346'}, {'image_id': 'ryct.2020200210.fig2', 'image_file_name': 'ryct.2020200210.fig2.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig2.jpg', 'caption': 'Image in 42-year-old man with no past medical history other than obesity intubated in the intensive care unit. Chest radiograph demonstrates diffuse dense opacities with small bilateral pneumothoraces (arrows) in addition to severe bilateral neck and chest wall subcutaneous emphysema. The etiology of the air leak is unknown but suspected to be related to mechanical ventilation and high positive end-expiratory pressure settings, a finding that has been previously associated with acute respiratory distress syndrome. The patient was confirmed to be positive for coronavirus disease 2019 with polymerase chain reaction testing.', 'hash': '447d50b1acbd65ce292a32ae47ef49f3779e9a41bac8a9d6c2119f9c34ccc7dc'}, {'image_id': 'ryct.2020200210.fig10', 'image_file_name': 'ryct.2020200210.fig10.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig10.jpg', 'caption': 'Venous thromboembolic disease in coronavirus disease 2019 (COVID-19). A, Doppler US image of the left lower extremity in a 57-year-old man with COVID-19 demonstrates nonocclusive thrombus in the popliteal vein (arrow). B, Pelvic CT scan in a 33-year-old man demonstrates nonocclusive thrombus in the right common femoral vein (arrow). C, CT chest angiogram in a 69-year-old man demonstrates saddle pulmonary embolus (arrow).', 'hash': '27060fd2f1e8a66267da9e86d36d5ca7ad6314b1cd3f9b59a0c6cac015656e6b'}, {'image_id': 'ryct200210suppf1', 'image_file_name': 'ryct200210suppf1.jpg', 'image_path': '../data/media_files/PMC7325394/ryct200210suppf1.jpg', 'caption': None, 'hash': 'd4514db87c226ff9bb8da6467d4fd751fc89c5083e20a917f9cda780ef243924'}, {'image_id': 'ryct.2020200210.fig11', 'image_file_name': 'ryct.2020200210.fig11.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig11.jpg', 'caption': 'Arterial thrombosis in coronavirus disease 2019 (COVID-19). A, Sagittal CT angiogram of the abdomen in a 66-year-old woman with COVID-19 demonstrates thrombus in the celiac artery (arrow). B, Axial CT angiogram in the same patient demonstrates thrombus in both renal arteries (arrows) with associated hypoperfusion changes in both kidneys.', 'hash': '81263aab6d75c5126fea76a4bbbd1fd1fbf54b3d2259e0644868dc9ef6eabe49'}, {'image_id': 'ryct.2020200210.fig3', 'image_file_name': 'ryct.2020200210.fig3.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig3.jpg', 'caption': 'Corresponding axial chest CT scan without intravenous contrast material in patient in Figure 1 shows typical findings of coronavirus disease 2019 with peripheral and lower lobe–predominant dense consolidative opacities with a rounded morphology and mild surrounding ground-glass opacification (arrows).', 'hash': '0b150f0bb237d4ea38938e1fe7545b47fcea44351b307f983f7a5252acc6490b'}, {'image_id': 'ryct.2020200210.fig4', 'image_file_name': 'ryct.2020200210.fig4.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig4.jpg', 'caption': 'A, Chest radiograph and B, axial non–contrast-enhanced chest CT scan in a 27-year-old man with no past medical history, who presented with a fever, vomiting, and myalgias of duration 3 days, demonstrate dense consolidation in the apicoposterior segment of the left upper lobe (arrows). The patient was confirmed to be positive for coronavirus disease 2019 with polymerase chain reaction testing. This single upper lobe involvement represents an atypical pattern of disease without any associated identifying factors in the patient’s history or presentation.', 'hash': 'a092c1b6831dfce63ba8748d14845b714e3cd3e6a952be5d1a0782cb0921243f'}, {'image_id': 'ryct.2020200210.fig12', 'image_file_name': 'ryct.2020200210.fig12.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig12.jpg', 'caption': 'Cerebral arterial thrombosis in coronavirus disease 2019 (COVID-19). A, Non–contrast-enhanced head CT scan in a 57-year-old man with COVID-19 demonstrates hypoattenuation throughout the left middle cerebral artery territory. B, CT angiogram in the same patient demonstrates focal occlusion of the left M2 branch (arrow) without distal reconstitution.', 'hash': 'b77198c9fd547a38c8edc6a449573f586ef977f761a620fabf71161da6084e5f'}, {'image_id': 'ryct.2020200210.fig9', 'image_file_name': 'ryct.2020200210.fig9.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig9.jpg', 'caption': 'A, Lung US in a 17-year-old boy being treated for coronavirus disease 2019, on bilevel positive airway pressure in the pediatric intensive care unit, shows consolidation in the left lung with multiple echogenic foci representing “air bronchograms” (arrow). B, Chest radiograph in the same patient reveals multiple patchy consolidative pulmonary opacities most predominantly within the left lower lobe.', 'hash': '3912bd3f38262ff5e091b5a6a9c4d3439df359e83b09ae94ee631191eb00a6cc'}, {'image_id': 'ryct.2020200210.fig7', 'image_file_name': 'ryct.2020200210.fig7.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig7.jpg', 'caption': 'Image in 26-year-old woman with a recent history of sleeve gastrectomy complicated by splenic vein thrombosis who presented to the emergency department with left lower quadrant abdominal pain. T1-weighted axial MRI with intravenous contrast material of the abdomen and pelvis incidentally noted peripheral signal intensity abnormalities in the right lung base (arrow). The patient subsequently tested positive for coronavirus disease 2019 with polymerase chain reaction testing.', 'hash': 'c361c6555bf3cc846eac225d9bc05f1d07283176421b2c7e5666cb4f571b268d'}, {'image_id': 'ryct.2020200210.fig1', 'image_file_name': 'ryct.2020200210.fig1.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig1.jpg', 'caption': 'A, Posteroanterior chest radiograph in a 29-year-old woman with no past medical history, who presented to the emergency department with 4 days of fever, cough, pleuritic chest pain, diarrhea, and myalgias, shows faint peripheral rounded opacities in a lower lung distribution (arrows). B, Chest radiograph in a 40-year-old man with a history of diabetes mellitus who presented from a group home with fever, cough, and shortness of breath of duration 1 week demonstrates diffuse bilateral opacities with dense consolidation in the mid to lower lungs. C, Portable chest radiograph in an intubated 50-year-old man with a history of hypertension who presented with 1 week of fever, cough, congestion, and myalgias. On his 7th day of admission, 14 days after symptom onset, chest radiograph demonstrates multiple bilateral diffuse hazy pulmonary opacities. The patient was noted to have elevated inflammatory markers including C-reactive protein, interleukin-6, d-dimer, lactate dehydrogenase, and fibrinogen. All patients were confirmed positive for coronavirus disease 2019 with polymerase chain reaction testing, and the patient in C died two days later.', 'hash': '7a607c8b230cff4d0ecec4317256bf84fb70f92dcc51893291221ab123334ad0'}, {'image_id': 'ryct.2020200210.fig6', 'image_file_name': 'ryct.2020200210.fig6.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig6.jpg', 'caption': 'Coronal chest CT scan in a 73-year-old woman with a history of hypertension and lupus and hospitalized for worsening respiratory status. Follow-up CT scan 30 days after initial symptoms demonstrates widespread reticulation with geographic regions of bronchiectasis and ground-glass opacity and clear demarcations between spared lobules, consistent with an organizing pattern.', 'hash': 'e27767da724e8608b7a83480b2fe19efc7bc05666c601538711c5e0f46c13303'}, {'image_id': 'ryct.2020200210.fig8', 'image_file_name': 'ryct.2020200210.fig8.jpg', 'image_path': '../data/media_files/PMC7325394/ryct.2020200210.fig8.jpg', 'caption': 'Images in 33-year-old man with history of human immunodeficiency virus and treated Hodgkin lymphoma undergoing PET/CT for oncologic restaging. B, Fused PET/CT imaging shows bilateral peripheral-predominant intense sites of fluorodeoxyglucose avidity that correspond to ground-glass and mixed attenuation opacities on A, CT scans. A maximum standardized uptake value of 9.98 was seen. The patient was asymptomatic at time of imaging but presented to the emergency department 10 days later after developing hypoxia with 85% oxygen saturation on room air. The patient was confirmed to be positive for coronavirus disease 2019 with polymerase chain reaction testing.', 'hash': '603e8826df8a58e85c9ac5e88e9efce7c4569e14f6d88f34320c93498a84b1e2'}] | {'ryct.2020200210.fig1': ['When baseline chest radiography is positive, COVID-19 manifests with consistent findings, the most common of which is hazy opacification, the likely radiographic correlate of ground-glass opacity (GGO) seen at CT (17). The opacities are sometimes rounded in morphology and have a peripheral and lower lung distribution (<xref ref-type="fig" rid="ryct.2020200210.fig1">Fig 1, <italic>A</italic></xref>). Lung findings may be unilateral or bilateral, and as the disease progresses, more of the mid to upper lungs may be affected. While uncommon, isolated opacities can appear in the upper lobes in the setting of mild disease.A). Lung findings may be unilateral or bilateral, and as the disease progresses, more of the mid to upper lungs may be affected. While uncommon, isolated opacities can appear in the upper lobes in the setting of mild disease.', 'As the disease progresses and becomes more severe, the opacities may coalesce and become denser, presenting as patchy consolidative opacities (<xref ref-type="fig" rid="ryct.2020200210.fig1">Fig 1, <italic>B</italic></xref>). These findings typically peak 10–12 days after symptom onset. Additionally, pulmonary opacification may become diffuse, mimicking the imaging (and clinical) presentation of diffuse alveolar damage, such as may be seen in the setting of acute respiratory distress syndrome (B). These findings typically peak 10–12 days after symptom onset. Additionally, pulmonary opacification may become diffuse, mimicking the imaging (and clinical) presentation of diffuse alveolar damage, such as may be seen in the setting of acute respiratory distress syndrome (<xref ref-type="fig" rid="ryct.2020200210.fig1">Fig 1, <italic>C</italic></xref>).C).', 'Corresponding axial chest CT scan without intravenous contrast material in patient in <xref ref-type="fig" rid="ryct.2020200210.fig1">Figure 1</xref> shows typical findings of coronavirus disease 2019 with peripheral and lower lobe–predominant dense consolidative opacities with a rounded morphology and mild surrounding ground-glass opacification (arrows). shows typical findings of coronavirus disease 2019 with peripheral and lower lobe–predominant dense consolidative opacities with a rounded morphology and mild surrounding ground-glass opacification (arrows).'], 'ryct.2020200210.fig2': ['While two-view posteroanterior and lateral chest radiography is the ideal radiographic technique, portable anteroposterior chest radiography is adequate in assessing parenchymal findings associated with COVID-19. By employing portable radiography, hospitals can limit transport of these highly contagious patients, as well as exposure to radiology staff. The American College of Radiology recommends that COVID-19 patients undergo only portable chest radiography as their primary means of imaging assessment (16). Performing serial portable chest radiography allows the radiologist and the treatment team to monitor progression of disease within the lungs. In addition, assessment of lines and tubes and potential complications such as pneumothorax, subcutaneous emphysema, and pneumomediastinum can be performed (<xref ref-type="fig" rid="ryct.2020200210.fig2">Fig 2</xref>).).'], 'ryct.2020200210.fig3': ['While chest radiography remains an adequate screening and assessment tool for COVID-19 in most patients, chest CT is far more sensitive, with early reports of up to 97% sensitivity (3). CT can detect early disease, as occult or subtle hazy opacities on chest radiographs appear as readily identifiable GGOs on CT scans (<xref ref-type="fig" rid="ryct.2020200210.fig3">Fig 3</xref>). The typical findings of COVID-19 at chest CT are multiple bilateral GGOs (57%) with or without consolidation (29%), often with a rounded morphology and peripheral and lower lung distribution (). The typical findings of COVID-19 at chest CT are multiple bilateral GGOs (57%) with or without consolidation (29%), often with a rounded morphology and peripheral and lower lung distribution (18). Sublobar and segmental consolidation, though less common, can also be seen (<xref ref-type="fig" rid="ryct.2020200210.fig4">Fig 4</xref>). On CT scans, GGO is defined as hazy increased lung attenuation with preservation of the bronchial and vascular margins, while consolidation refers to denser opacification that obscures vessel margins and airway walls. Pure GGO lesions are characteristic of mild or early COVID-19 pneumonia with progression on serial CT scans showing increased lung involvement and development of mixed attenuation (the second most prevalent pattern). In addition, GGO with superimposed interlobular septal thickening and visible intralobular lines (“crazy paving”) may be present, particularly later in disease time course (). On CT scans, GGO is defined as hazy increased lung attenuation with preservation of the bronchial and vascular margins, while consolidation refers to denser opacification that obscures vessel margins and airway walls. Pure GGO lesions are characteristic of mild or early COVID-19 pneumonia with progression on serial CT scans showing increased lung involvement and development of mixed attenuation (the second most prevalent pattern). In addition, GGO with superimposed interlobular septal thickening and visible intralobular lines (“crazy paving”) may be present, particularly later in disease time course (15).'], 'ryct.2020200210.fig5': ['CT abnormalities progress rapidly after symptom onset and are reported to peak between days 6 and 13 of the illness (19,20). In later and more severe stages, consolidation can become the predominant abnormality and can become diffusely distributed with a more reticular configuration (<xref ref-type="fig" rid="ryct.2020200210.fig5">Fig 5</xref>). There is an expected but variable pattern of resolution and healing thereafter—an evolution consistent with organization and fibrosis that occurs after any form of acute lung injury (). There is an expected but variable pattern of resolution and healing thereafter—an evolution consistent with organization and fibrosis that occurs after any form of acute lung injury (21). In one study, 66 of 70 patients (94%) discharged from the hospital had residual disease on their latest CT scans, most often GGO (19).'], 'ryct.2020200210.fig6': ['Another relatively infrequently reported finding is the atoll sign (or “reverse halo” sign) on CT scans, defined as a rounded area of more lucent GGO surrounded by a complete or almost complete ring of denser consolidation (15). This finding is typically encountered in the subacute to chronic stages of lung injury with the development of organization and early fibrosis, which may be a reason why the earliest COVID-19 investigators found this imaging feature to be infrequent (<xref ref-type="fig" rid="ryct.2020200210.fig6">Fig 6</xref>). Of note, the atoll sign can also be concerning for pulmonary infarction (). Of note, the atoll sign can also be concerning for pulmonary infarction (23). In this clinical context, patients should undergo further workup for pulmonary embolism, either through chest CT pulmonary angiography or venous duplex ultrasonography when CT pulmonary angiography is contraindicated; these considerations are discussed in further detail below. The CT halo sign, defined as consolidative nodules or masses surrounded by GGO, is another atypical finding reported in COVID-19. It has also been seen in other viral pneumonias, angioinvasive fungal infections, hypervascular metastases, and vasculitides and may be related to perilesional hemorrhage or edema.'], 'ryct.2020200210.fig7': ['To date, the pulmonary MRI features of COVID-19 have not been described. Currently, cardiac MRI is not being performed for many patients with elevations in troponin or suspected of having myocardial injury related to myocarditis, as part of a risk and benefit assessment related to infection control measures. Due to the overwhelming prevalence of the disease, MRI examinations performed for various indications, including cardiac, vascular, and upper abdominal MRI, can demonstrate incidental findings related to COVID-19 in the pulmonary parenchyma. The pulmonary distribution of COVID-19 at MRI is consistent with CT and chest radiography, including basilar- and peripheral-predominant disease. On MR images, the parenchymal changes of COVID-19 pneumonia appear as regions of abnormal increased signal intensity on both T1- and T2-weighted sequences, corresponding to the ground-glass or consolidative opacities seen on chest radiographs and CT scans (<xref ref-type="fig" rid="ryct.2020200210.fig7">Fig 7</xref>). Cardiac MRI may also have some useful applications, as myocarditis and cardiomyopathy have been described in COVID-19 patients (). Cardiac MRI may also have some useful applications, as myocarditis and cardiomyopathy have been described in COVID-19 patients (31). With only two reported cardiac MRI cases in the literature to date, the cardiac MRI findings of COVID-19 would be expected to be consistent with myocarditis, showing regional or global wall motion abnormalities on cine steady-state free precession images, more diffuse rise in T1 relaxation values on T1 mapping images, late gadolinium enhancement in a midmyocardial or transmural pattern, and, if acute, signal hyperintensity representing edema on electrocardiography-gated black blood T2-weighted sequence images (31,32).'], 'ryct.2020200210.fig8': ['Few reports exist of FDG PET/CT findings in COVID-19 (6–8). However, commonalities among these reports illustrate general themes. The characteristic ground-glass and mixed-attenuation CT findings discussed above correspond to sites of FDG avidity (<xref ref-type="fig" rid="ryct.2020200210.fig8">Fig 8</xref>). Reported maximum standardized uptake values have ranged from 4.6 to 12.2 (). Reported maximum standardized uptake values have ranged from 4.6 to 12.2 (6–8). Furthermore, even in the absence of anatomically enlarged thoracic lymph nodes, radiotracer uptake is common in lymph nodes, particularly in the hilar, supraclavicular, and mediastinal regions (7).'], 'ryct.2020200210.fig9': ['Chest US has been useful as a POC evaluation in emergency and intensive care settings (39). Reports have cited lung US as valuable for imaging of acute respiratory failure and have advised bedside US use in the emergency department setting for prompt diagnosis of COVID-19 pneumonia (5,40). Commonly reported findings include thickened pleural lines, B-lines (multifocal, discrete, or confluent), consolidative patterns with or without air bronchograms (<xref ref-type="fig" rid="ryct.2020200210.fig9">Fig 9</xref>), and A-lines during the recovery phase (), and A-lines during the recovery phase (40). Some prospective studies have reported superior sensitivity of lung US in diagnosing pneumonia when compared with chest radiography (41). Many physicians in the emergency department or intensive care unit settings have advocated for the widespread adoption of POC US, touting its ease of use, repeatability, low cost, absence of radiation exposure, and triage optimization (42). In particular, its lack of ionizing radiation makes it appealing for children and pregnant patients. Published data regarding the risk of disease transmission to ultrasonography technologists is currently unavailable; however, this consideration should be noted when determining appropriate use of resources.'], 'ryct.2020200210.fig10': ['The hypercoagulability seen in COVID-19 may result in deep vein thrombosis, manifesting as filling defects at Doppler US or venous phase CT. (<xref ref-type="fig" rid="ryct.2020200210.fig10">Fig 10</xref>). In the unfortunate situation that these clots dislodge and migrate to the heart, a pulmonary embolism can form, creating filling defects detectable at CT angiography (). In the unfortunate situation that these clots dislodge and migrate to the heart, a pulmonary embolism can form, creating filling defects detectable at CT angiography (<xref ref-type="fig" rid="ryct.2020200210.fig10">Fig 10</xref>).).'], 'ryct.2020200210.fig11': ['Cases of noncerebral arterial thromboembolic disease have also been reported and may involve the celiac trunk or renal arteries, leading to downstream hypoperfusion changes (<xref ref-type="fig" rid="ryct.2020200210.fig11">Fig 11</xref>).).'], 'ryct.2020200210.fig12': ['Cerebral infarction has also been described in association with COVID-19, with a recent series reporting large vessel occlusions in young patients, raising the suspicion for a thromboembolic etiology (64,65). These infarcts may be evident on non–contrast-enhanced CT as hypoattenuated large vessel territories or at CT angiography as focal arterial occlusions (<xref ref-type="fig" rid="ryct.2020200210.fig12">Fig 12</xref>).).']} | COVID-19: A Multimodality Review of Radiologic Techniques, Clinical Utility, and Imaging Features | null | Radiol Cardiothorac Imaging | 1590994800 | None | null | other | PMC7325394 | null | null | [
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] | Radiol Cardiothorac Imaging. 2020 Jun 1; 2(3):e200210 | NO-CC CODE |
|
Computed tomography scan showing right angle junction (arrow) of right subclavian vein with superior vena cava. | rmhp-4-027f3 | 7 | 415f43033033808eb9d462f949fc45923c010c45fc06c97fb851c47109641a23 | rmhp-4-027f3.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
405,
279
] | [{'image_id': 'rmhp-4-027f3', 'image_file_name': 'rmhp-4-027f3.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f3.jpg', 'caption': 'Computed tomography scan showing right angle junction (arrow) of right subclavian vein with superior vena cava.', 'hash': '415f43033033808eb9d462f949fc45923c010c45fc06c97fb851c47109641a23'}, {'image_id': 'rmhp-4-027f4', 'image_file_name': 'rmhp-4-027f4.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f4.jpg', 'caption': 'Ultrasound probe prepared within sterile sheath.', 'hash': 'a7d7db66dcaa6962c8da6ae3efb7312fc08aa3629e62bddea1c597bb11629033'}, {'image_id': 'rmhp-4-027f11', 'image_file_name': 'rmhp-4-027f11.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f11.jpg', 'caption': 'Computed tomography scan demonstrating apposition of left subclavian vein to pleura (arrows).', 'hash': 'de120e80c6b91f20ec72ce4f79cc3a1334c1ba206d93e2b0152c6d38ce966587'}, {'image_id': 'rmhp-4-027f10', 'image_file_name': 'rmhp-4-027f10.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f10.jpg', 'caption': 'Computed tomography scan demonstrating apposition of right subclavian vein to pleura (arrows).', 'hash': '7254fe0d3f547a66b91bfa05be01364f751a7466162b0c440760fc70a2f44d2e'}, {'image_id': 'rmhp-4-027f5', 'image_file_name': 'rmhp-4-027f5.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f5.jpg', 'caption': 'Sedillot’s triangle: sternal head of sternocleidomastoid (yellow arrow), clavicular head sternocleidomastoid (orange arrow), clavicle (red arrow); and position of appropriate cutaneous puncture at apex of triangle (black star).', 'hash': '5ddc93fa29007615ca9c6246355a180c3e1791dea20fd312df57b1d545ed131f'}, {'image_id': 'rmhp-4-027f2', 'image_file_name': 'rmhp-4-027f2.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f2.jpg', 'caption': 'Computed tomography scan showing venous course from right internal jugular vein (blue arrows) and venous course from left subclavian vein (yellow arrow) through the innominate vein (white arrow) to superior vena cava (orange arrow); course from left internal jugular vein (green arrow) with turns at junctions with innominate vein and superior vena cava.', 'hash': '0868e11bb3d66e23ea995105c63e038ce96afff71200395fc817d199469ae13d'}, {'image_id': 'rmhp-4-027f8', 'image_file_name': 'rmhp-4-027f8.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f8.jpg', 'caption': 'Ultrasound image of right internal jugular vein compressed by gentle probe pressure (white star) and carotid artery (yellow star).', 'hash': '6e32be38dac4831979453a660f7989b11dcbb7b6701dfb2ad4cc48ecf8f9ab82'}, {'image_id': 'rmhp-4-027f1', 'image_file_name': 'rmhp-4-027f1.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f1.jpg', 'caption': 'Long-term right internal jugular venous catheter (tip at orange arrow) appropriately positioned relative to right tracheobronchial angle (at yellow arrow).', 'hash': '5e8fc0966acb5f7397446d3d228caa0045ec1ebde672316e9426d31e58f2c46a'}, {'image_id': 'rmhp-4-027f6', 'image_file_name': 'rmhp-4-027f6.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f6.jpg', 'caption': 'External jugular vein crossing the posterior border of sternocleidomastoid (arrow), Sedillot’s triangle (red star), and sternal notch (black star).', 'hash': '5e18215a2bdfc58e9d55f6c6ceda6af65728cd4dac7f38ead3658f8003983237'}, {'image_id': 'rmhp-4-027f7', 'image_file_name': 'rmhp-4-027f7.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f7.jpg', 'caption': 'Ultrasound image of right carotid artery (yellow star) and right internal jugular vein (white star).', 'hash': '054b816a17d45f0984d0ad7b153ab7cf953404c89a972efd25120ab13913353c'}, {'image_id': 'rmhp-4-027f9', 'image_file_name': 'rmhp-4-027f9.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f9.jpg', 'caption': 'The “break” of the clavicle (arrow) and position of appropriate cutaneous puncture (black star). Note that head and neck drapes must always be placed with care to avoid potential airway obstruction and to allow appropriate airway assessment.', 'hash': '8e34292ac3fe18cc329e20b3b5000853a9d00ab24b75787b198e40a41082f5fe'}] | {'rmhp-4-027f1': ['Ideally the catheter tip lies at the junction of the superior vena cava and the right atrium. This location ensures a proximal position with high blood flow which prevents thrombosis (especially of concern with parenteral nutrition solutions and chemotherapeutic agents) and yet lies outside the atrium and thus prevents arrhythmias from catheter tip irritation of the right atrial wall. The surface landmark corresponding to this position is the angle of Louis, ie, the junction between the manubrium and the sternum. Measurement of the distance between the cutaneous puncture site and the angle of Louis along the trajectory of the vein allows the operator to estimate the appropriate length of catheter for insertion. Pikwer et al found catheter tip malposition, defined as extrathoracic or ventricular locations, in 3.3% of insertions; the highest incidence occurring from the right subclavian approach (9.1%) and the lowest from the right internal jugular approach (1.4%).10 The present authors consider distal intrathoracic and atrial locations to also represent malpositions, and thus the data of Pikwer et al may under-represent the incidence. An appropriate radiographic landmark to guide appropriate catheter tip position on chest x-ray is the right tracheobronchial angle, which is always inferior to the cephalad origin of the superior vena cava by a median distance of 1.5 cm; this landmark is always at least 2.9 cm superior to the atriocaval junction.11 Thus, catheter tips positioned approximately 3 cm below the right tracheobronchial angle will lie in close proximity to the atriocaval junction but will remain extracardiac in location (<xref ref-type="fig" rid="rmhp-4-027f1">Figure 1</xref>). Fluoroscopically-assisted measurements of guidewire length from the cutaneous puncture site to the superior vena cava-atrial junction have revealed mean distances of 16.0 cm for the right internal jugular, 18.4 cm for the right subclavian, 19.1 cm for the left internal jugular, and 21.2 cm for the left subclavian veins, respectively.). Fluoroscopically-assisted measurements of guidewire length from the cutaneous puncture site to the superior vena cava-atrial junction have revealed mean distances of 16.0 cm for the right internal jugular, 18.4 cm for the right subclavian, 19.1 cm for the left internal jugular, and 21.2 cm for the left subclavian veins, respectively.12 These measurements are useful guides, but long-term catheters should be positioned precisely under fluoroscopy, and the position of short-term lines should be confirmed with a postprocedure chest x-ray.'], 'rmhp-4-027f2': ['Large caliber catheters, such as dialysis catheters, are placed after the passage of a stiff dilator creates a subcutaneous tract. Soft silastic catheters for long-term use are too flimsy to be placed over a guidewire; they are placed through a peel-away introducer sheath which is itself placed while loaded onto an obturating dilator. These dilators, being wide-bore and stiff, cause serious injury to any structure unintentionally punctured. Vascular injury may lead to life-threatening hemorrhage or cardiac tamponade.13 The danger of vessel injury makes an understanding of the underlying vein trajectory critical. From the right internal jugular and left subclavian approaches, the veins respectively take straight and gently curving trajectories to the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). However, the right subclavian vein takes a near-right angle turn into the superior vena cava (). However, the right subclavian vein takes a near-right angle turn into the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f3">Figure 3</xref>), and the left internal jugular approach incorporates two turns, one into the brachiocephalic vein and a second into the superior vena cava (), and the left internal jugular approach incorporates two turns, one into the brachiocephalic vein and a second into the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). These turns create potential for the venous side walls to be punctured by a dilator failing to negotiate a curve appropriately.). These turns create potential for the venous side walls to be punctured by a dilator failing to negotiate a curve appropriately.', 'It is important to recognize that the deep courses of the left and right internal jugular veins are not bilaterally symmetric. The right internal jugular vein follows a direct course inferiorly to the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). The left internal jugular vein courses to the right after it joins the left subclavian vein to become the innominate vein, and the innominate vein subsequently courses inferiorly as it joins the superior vena cava (). The left internal jugular vein courses to the right after it joins the left subclavian vein to become the innominate vein, and the innominate vein subsequently courses inferiorly as it joins the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). The angulation at the junction of the left internal jugular vein and innominate vein can create difficulties when passing catheters through introducer sheaths. First, the introducer sheath may become kinked as it negotiates this angle, preventing the passage of an intravascular catheter through the sheath. In this event, seen clinically during the passage of soft, long-term tunneled catheters through “peel-away” introducer sheaths, the introducer sheath must be partially withdrawn so that it will straighten and allow passage of the catheter; if the sheath becomes permanently crimped and narrowed, it must be exchanged for a new sheath inserted to a shallower intravenous depth. Alternatively, the tip of the introducer sheath may lie so close to the inferior wall of the innominate vein that the catheter kinks as it exits the introducer sheath. This latter situation will cause damping of pressures monitored through pulmonary artery or central venous pressure catheters, which can be rectified by partial withdrawal of the introducer. Finally, a stiff dilator inserted to a maximal depth has the potential to puncture the inferior wall of the innominate vein at the jugular-innominate junction. To prevent such complications, dilators should be inserted only far enough to dilate the subcutaneous tract as discussed earlier.). The angulation at the junction of the left internal jugular vein and innominate vein can create difficulties when passing catheters through introducer sheaths. First, the introducer sheath may become kinked as it negotiates this angle, preventing the passage of an intravascular catheter through the sheath. In this event, seen clinically during the passage of soft, long-term tunneled catheters through “peel-away” introducer sheaths, the introducer sheath must be partially withdrawn so that it will straighten and allow passage of the catheter; if the sheath becomes permanently crimped and narrowed, it must be exchanged for a new sheath inserted to a shallower intravenous depth. Alternatively, the tip of the introducer sheath may lie so close to the inferior wall of the innominate vein that the catheter kinks as it exits the introducer sheath. This latter situation will cause damping of pressures monitored through pulmonary artery or central venous pressure catheters, which can be rectified by partial withdrawal of the introducer. Finally, a stiff dilator inserted to a maximal depth has the potential to puncture the inferior wall of the innominate vein at the jugular-innominate junction. To prevent such complications, dilators should be inserted only far enough to dilate the subcutaneous tract as discussed earlier.', 'As with the internal jugular veins, the deep courses of the right and left subclavian veins are not bilaterally symmetric. The venous course from the left subclavian vein arcs through the innominate vein to the superior vena cava in a gentle curve (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). However, the right subclavian vein makes a more sharply angled turn into the superior vena cava as it is joined by the internal jugular vein (). However, the right subclavian vein makes a more sharply angled turn into the superior vena cava as it is joined by the internal jugular vein (<xref ref-type="fig" rid="rmhp-4-027f3">Figure 3</xref>). This sharp angle of the right subclavian vein can lead to difficulties with placing catheters through introducer sheaths. If the introducer sheath lies too far medially relative to the lumen of the superior vena cava, lines may either kink as they pass into the superior vena cava or be passed into the contralateral subclavian and axillary veins. Related to the bilateral asymmetry, malpositioning of catheters into the contralateral subclavian or either internal jugular vein occurs more frequently from right than from left subclavian venous access.). This sharp angle of the right subclavian vein can lead to difficulties with placing catheters through introducer sheaths. If the introducer sheath lies too far medially relative to the lumen of the superior vena cava, lines may either kink as they pass into the superior vena cava or be passed into the contralateral subclavian and axillary veins. Related to the bilateral asymmetry, malpositioning of catheters into the contralateral subclavian or either internal jugular vein occurs more frequently from right than from left subclavian venous access.52'], 'rmhp-4-027f4': ['Relative advantages of real-time ultrasonographic localization are discussed below for each vessel. Given the superficial location of the central veins at the sites of venipuncture, a high frequency probe of 7.5 mHz creates optimal images. Ultrasound equipment can be easily used within a sterile field (<xref ref-type="fig" rid="rmhp-4-027f4">Figure 4</xref>). Ultrasound does not obviate the need for anatomic knowledge, so surface anatomic landmarks remain necessary for orientation of both cannulating needles and the ultrasound probe itself. However, ultrasound affords the operator an “inside view” of vascular anatomy and eliminates the total reliance on mind’s eye visualization of deep structures that was originally an inherent part of all percutaneous techniques. Real-time sonography provides a means to aim the cannulating needle directly toward the internal jugular, axillary, and femoral veins while avoiding puncture of the accompanying arteries. Needle guides which orient the needle within the field of view along the path of the ultrasound beam can facilitate venipuncture. Although subclavian cannulation remains a blind technique, the use of ultrasound has improved outcomes for internal jugular vein cannulation, and is considered a current standard of care for cannulation at this site.). Ultrasound does not obviate the need for anatomic knowledge, so surface anatomic landmarks remain necessary for orientation of both cannulating needles and the ultrasound probe itself. However, ultrasound affords the operator an “inside view” of vascular anatomy and eliminates the total reliance on mind’s eye visualization of deep structures that was originally an inherent part of all percutaneous techniques. Real-time sonography provides a means to aim the cannulating needle directly toward the internal jugular, axillary, and femoral veins while avoiding puncture of the accompanying arteries. Needle guides which orient the needle within the field of view along the path of the ultrasound beam can facilitate venipuncture. Although subclavian cannulation remains a blind technique, the use of ultrasound has improved outcomes for internal jugular vein cannulation, and is considered a current standard of care for cannulation at this site.14,15'], 'rmhp-4-027f5': ['There are three percutaneous approaches to the internal jugular vein, ie, anterior, central, and posterior. The authors’ preferred approach for internal jugular cannulation is the central approach. The essential surface anatomy is comprised of the borders of Sedillot’s triangle, the sternal head of the sternocleidomastoid muscle medially, the clavicular head of the sternocleidomastoid laterally, and the superior border of the medial third of the clavicle inferiorly (<xref ref-type="fig" rid="rmhp-4-027f5">Figure 5</xref>). For the awake supine patient, the borders of this triangle are accentuated by active head-raising. For the noncooperative or obese patient, the triangle is best defined by initial palpation of the trachea and then drawing the fingers laterally over the sternal head of the sternocleidomastoid into the depression of the triangle. Cannulation begins with cutaneous puncture at the superior apex of this triangle. The needle and syringe are angled 45° off a coronal plane, and the needle is advanced in a sagittal plane.). For the awake supine patient, the borders of this triangle are accentuated by active head-raising. For the noncooperative or obese patient, the triangle is best defined by initial palpation of the trachea and then drawing the fingers laterally over the sternal head of the sternocleidomastoid into the depression of the triangle. Cannulation begins with cutaneous puncture at the superior apex of this triangle. The needle and syringe are angled 45° off a coronal plane, and the needle is advanced in a sagittal plane.'], 'rmhp-4-027f6': ['To initiate the posterior approach, the needle is placed at the posterior border of the sternocleidomastoid muscle, at a point one-third of the way from the sternoclavicular joint to the mastoid process. The external jugular vein crosses the sternocleidomastoid muscle at this point and, when visible, serves as a useful landmark (<xref ref-type="fig" rid="rmhp-4-027f6">Figure 6</xref>). The needle is advanced toward the ipsilateral sternoclavicular joint at an angle of 30°–40° off the skin.). The needle is advanced toward the ipsilateral sternoclavicular joint at an angle of 30°–40° off the skin.16,19 The cutaneous puncture site for the anterior approach lies at the medial border of the sternocleidomastoid at the level of the cricoid cartilage. The needle tip should pass medial to the sternocleidomastoid directed 30°–45° posteriorly from a coronal plane and 15°–45° laterally from a sagittal plane.'], 'rmhp-4-027f7': ['Ultrasound imaging through Sedillot’s triangle will demonstrate the carotid artery and internal jugular vein as two sonolucent circles. The artery is recognized as the smaller diameter, noncompressible vessel with a visible pulsation (<xref ref-type="fig" rid="rmhp-4-027f7">Figure 7</xref>).).'], 'rmhp-4-027f8': ['Cervical vessel diameters have been measured by ultrasound for a variety of clinical correlations. Common carotid artery diameter is reliably less than 1 cm.28–31 Internal jugular vein diameter is generally greater than one 1 cm, 23,24,32 but may be smaller.21,33 Although the internal jugular vein may generally be differentiated from the common carotid artery by its larger diameter, the diameters of these vessels will rarely approximate each other, and therefore, the internal jugular vein and common carotid artery are most reliably differentiated by their compressibility and pulsation, respectively. The internal jugular vein is easily compressible; gentle pressure applied to the ultrasound probe will completely flatten the diameter of the internal jugular vein while leaving the diameter of the carotid artery unchanged (<xref ref-type="fig" rid="rmhp-4-027f8">Figure 8</xref>). The cannulating needle and/or tissue compression it causes as it is advanced beneath the cutaneous surface can be visualized in real time by ultrasound, allowing the ultrasound image to guide puncture of the internal jugular vein at a 12 o’clock position and avoid unintended puncture of other structures.). The cannulating needle and/or tissue compression it causes as it is advanced beneath the cutaneous surface can be visualized in real time by ultrasound, allowing the ultrasound image to guide puncture of the internal jugular vein at a 12 o’clock position and avoid unintended puncture of other structures.'], 'rmhp-4-027f9': ['The goal of subclavian venipuncture is to pass a needle inferior to the clavicle and superior to the first rib to access the subclavian vein as it courses over the first rib. The appropriate course for the needle passes immediately beneath the junction of the medial one-third and lateral two-thirds of the clavicle. This junction, ie, the “break” of the clavicle,42 is the point at which the anterior convexity of the medial clavicle transitions into an anterior concavity laterally (<xref ref-type="fig" rid="rmhp-4-027f9">Figure 9</xref>). The appropriate point for cutaneous puncture lies 1–2 cm inferior and lateral to the clavicular transition point (). The appropriate point for cutaneous puncture lies 1–2 cm inferior and lateral to the clavicular transition point (<xref ref-type="fig" rid="rmhp-4-027f9">Figure 9</xref>). Cutaneous puncture at this point facilitates passage of the needle inferior to the clavicle. A cutaneous puncture site closer to the clavicle creates difficulty maneuvering the needle beneath the clavicle. More medial cannulation may be impeded by calcification of the costoclavicular ligament. As the needle is advanced, it must remain absolutely parallel to the floor; if the needle is directed posteriorly to negotiate the clavicle, the risk of pneumothorax is greatly increased. Only gentle pressure from the operator’s nondominant thumb is necessary to depress the needle in a flat coronal plane beneath the clavicle if the correct cutaneous puncture site is chosen. As the needle is advanced from the cutaneous puncture site to a point beneath the clavicular transition point, its tip should be aimed just above the tip of the operator’s nondominant index finger placed in the sternal notch. The needle is advanced along this course passing through the subclavius muscle until the subclavian vein is accessed.). Cutaneous puncture at this point facilitates passage of the needle inferior to the clavicle. A cutaneous puncture site closer to the clavicle creates difficulty maneuvering the needle beneath the clavicle. More medial cannulation may be impeded by calcification of the costoclavicular ligament. As the needle is advanced, it must remain absolutely parallel to the floor; if the needle is directed posteriorly to negotiate the clavicle, the risk of pneumothorax is greatly increased. Only gentle pressure from the operator’s nondominant thumb is necessary to depress the needle in a flat coronal plane beneath the clavicle if the correct cutaneous puncture site is chosen. As the needle is advanced from the cutaneous puncture site to a point beneath the clavicular transition point, its tip should be aimed just above the tip of the operator’s nondominant index finger placed in the sternal notch. The needle is advanced along this course passing through the subclavius muscle until the subclavian vein is accessed.'], 'rmhp-4-027f10': ['Medial to the anterior scalene muscle and first rib, the posterior relationships of the subclavian vein are the phrenic nerve (as it swings medially off the muscle), the internal mammary artery, and the apical pleura. The subclavian artery arcs more superiorly here so the vein is primarily apposed to the pleura. Thus, a venipuncture needle advanced too deeply at this level will puncture the pleura and lung. Given the conical shape of the superior chest cavity, inferior (caudad) angulation of the probing needle places the needle on a shorter course to the pleura (either through or inferior to the vein) and increases the likelihood of pneumothorax. Advancing the needle perfectly horizontally in a coronal plane places the needle on a trajectory that maximizes an encounter with vein before pleura. Consequently, pneumothorax is avoided by keeping the needle and syringe absolutely parallel to the floor. If the operator lifts the needle and syringe off the chest wall, angling the needle tip more deeply, passage into the pleural space and lung becomes much more likely because the subclavian veins are immediately apposed to pleura posteriorly (<xref ref-type="fig" rid="rmhp-4-027f10">Figures 10</xref> and and <xref ref-type="fig" rid="rmhp-4-027f11">11</xref>). For this reason, chronic forward rotation of the shoulders which prevent a flat horizontal course for the cannulating needle is a relative contraindication to subclavian cannulation.). For this reason, chronic forward rotation of the shoulders which prevent a flat horizontal course for the cannulating needle is a relative contraindication to subclavian cannulation.']} | Anatomic considerations for central venous cannulation | [
"Internal jugular vein",
"cannulation",
"ultrasound",
"venipuncture"
] | Risk Manag Healthc Policy | 1302678000 | Central venous cannulation is a commonly performed procedure which facilitates resuscitation, nutritional support, and long-term vascular access. Mechanical complications most often occur during insertion and are intimately related to the anatomic relationship of the central veins. Working knowledge of surface and deep anatomy minimizes complications. Use of surface anatomic landmarks to orient the deep course of cannulating needle tracts appropriately comprises the crux of complication avoidance. The authors describe use of surface landmarks to facilitate safe placement of internal jugular, subclavian, and femoral venous catheters. The role of real-time sonography as a safety-enhancing adjunct is reviewed. | [] | other | PMC3270925 | null | 66 | [
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"{'Citation': 'Kilbourne MJ, Bochicchio GV, Scalea T, Xiao Y. Avoiding common technical errors in subclavian central venous catheter placement. J Am Coll Surg. 2009;208:104–109.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19228511'}}}",
"{'Citation': 'Von Goedecke A, Keller C, Moriggl B, et al. An anatomic landmark to simplify subclavian vein cannulation: The “deltoid tuberosity”. Anesth Analg. 2005;100:623–628.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15728041'}}}",
"{'Citation': 'Tripathi M, Tripathi M. Subclavian vein cannulation: An approach with definite landmarks. Ann Thorac Surg. 1996;61:238–240.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8561571'}}}",
"{'Citation': 'Moran SG, Peoples JB. The deltopectoral triangle as a landmark for percutaneous infraclavicular cannulation of the subclavian vein. Angiology. 1993;44:683–686.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8357093'}}}",
"{'Citation': 'Czarnik T, Gawda R, Perkowski T, Weron R. Supraclavicular approach is an easy and safe method of subclavian vein catheterization even in mechanically ventilated patients. Anesthesiology. 2009;111:334–339.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19602954'}}}",
"{'Citation': 'Cunningham SC, Gallmeier E. Supraclavicular approach for central venous catheterization: “Safer, simpler, speedier”. J Am Coll Surg. 2007;205:514–516.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17765171'}}}",
"{'Citation': 'Nevarre DR, Domingo OH. Supraclavicular approach to subclavian catheterization: review of the literature and results of 178 attempts by the same operator. J Trauma. 1997;42:305–309.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9042887'}}}",
"{'Citation': 'Jung CW, Seo JH, Lee W, Bahk JH. A novel supraclavicular approach to the right subclavian vein based on three-dimensional computed tomography. Anesth Analg. 2007;105:200–204.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17578976'}}}",
"{'Citation': 'Jesseph JM, Conces DJ, Augustyn GT. Patient positioning for subclavian vein catheterization. Arch Surg. 1987;122:1207–1209.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3662802'}}}",
"{'Citation': 'Unal AE, Bayar S, Arat M, Ilhan O. Malpositioning of Hickman catheters, left versus right sided attempts. Transfus Apher Sci. 2003;28:9–12.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12620263'}}}",
"{'Citation': 'Arrighi DA, Farnell MB, Mucha P, Ilstrup DM, Anderson DL. Prospective, randomized trial of rapid venous access for patients in hypovolemic shock. Ann Emerg Med. 1989;18:927–930.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2669571'}}}",
"{'Citation': 'Aitken DR, Minton JP. The “pinch-off sign”: A warning of impending problems with permanent subclavian catheters. Am J Surg. 1984;148:633–636.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '6496853'}}}",
"{'Citation': 'Hinke DH, Zandt-Stastny DA, Goodman LR, Quebbeman EJ, Krzywda EA, Andris DA. Pinch-off syndrome: A complication of implantable subclavian venous access devices. Radiology. 1990;177:353–356.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2217768'}}}",
"{'Citation': 'Koonings PP, Given FT. Long-term experience with a totally implanted catheter system in gynecologic oncologic patients. J Am Coll Surg. 1994;178:164–166.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8173727'}}}",
"{'Citation': 'Mirza B, Vanek VW, Kupensky DT. Pinch-off syndrome: Case report and collective review of the literature. Am Surg. 2004;70:635–644.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15279190'}}}",
"{'Citation': 'Andris DA, Krzywda EA. Catheter pinch-off syndrome: Recognition and management. J Intraven Nurs. 1997;20:233–237.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9369623'}}}",
"{'Citation': 'Lafreniere R. Indwelling subclavian catheters and a visit with the “pinched-off sign”. J Surg Oncol. 1991;47:261–264.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1650409'}}}",
"{'Citation': 'Surov A, Wienke A, Carter JM, et al. Intravascular embolization of venous catheter – causes, clinical signs, and management: A systematic review. J Parenter Enteral Nutr. 2009;33:677–685.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19675301'}}}",
"{'Citation': 'Andris DA, Krzywda EA, Schulte W, Ausman R, Quebbeman EJ. Pinch-off syndrome: A rare etiology for central venous catheter occlusion. J Parenter Enteral Nutr. 1994;18:531–533.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7602729'}}}",
"{'Citation': 'Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavian-vein catheterization. N Engl J Med. 1994;331:1735–1738.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7984193'}}}",
"{'Citation': 'Pirotte T. Ultrasound-guided vascular access in adults and children: Beyond the internal jugular vein puncture. Acta Anaesthesiol Belg. 2008;59:157–166.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19051447'}}}",
"{'Citation': 'Skolnick ML. The role of sonography in the placement and management of jugular and subclavian central venous catheters. AJR Am J Roentgenol. 1994;163:291–295.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8037017'}}}",
"{'Citation': 'Gualtieri E, Deppe SC, Sipperly ME, Thompson DR. Subclavian venous catheterization: Greater success rate for less experienced operators using ultrasound guidance. Crit Care Med. 1995;23:692–697.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7661944'}}}",
"{'Citation': 'Taylor BL, Yellowlees I. Central venous cannulation using the infraclavicular axillary vein. Anesthesiology. 1990;72:55–58.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2297133'}}}",
"{'Citation': 'Merrer J, De Jonghe B, Golliot F, et al. Complications of femoral and subclavian venous catheterization in critically ill patients. JAMA. 2001;286:700–707.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11495620'}}}"
] | Risk Manag Healthc Policy. 2011 Apr 13; 4:27-39 | NO-CC CODE |
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Computed tomography scan showing venous course from right internal jugular vein (blue arrows) and venous course from left subclavian vein (yellow arrow) through the innominate vein (white arrow) to superior vena cava (orange arrow); course from left internal jugular vein (green arrow) with turns at junctions with innominate vein and superior vena cava. | rmhp-4-027f2 | 7 | 0868e11bb3d66e23ea995105c63e038ce96afff71200395fc817d199469ae13d | rmhp-4-027f2.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
405,
311
] | [{'image_id': 'rmhp-4-027f3', 'image_file_name': 'rmhp-4-027f3.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f3.jpg', 'caption': 'Computed tomography scan showing right angle junction (arrow) of right subclavian vein with superior vena cava.', 'hash': '415f43033033808eb9d462f949fc45923c010c45fc06c97fb851c47109641a23'}, {'image_id': 'rmhp-4-027f4', 'image_file_name': 'rmhp-4-027f4.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f4.jpg', 'caption': 'Ultrasound probe prepared within sterile sheath.', 'hash': 'a7d7db66dcaa6962c8da6ae3efb7312fc08aa3629e62bddea1c597bb11629033'}, {'image_id': 'rmhp-4-027f11', 'image_file_name': 'rmhp-4-027f11.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f11.jpg', 'caption': 'Computed tomography scan demonstrating apposition of left subclavian vein to pleura (arrows).', 'hash': 'de120e80c6b91f20ec72ce4f79cc3a1334c1ba206d93e2b0152c6d38ce966587'}, {'image_id': 'rmhp-4-027f10', 'image_file_name': 'rmhp-4-027f10.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f10.jpg', 'caption': 'Computed tomography scan demonstrating apposition of right subclavian vein to pleura (arrows).', 'hash': '7254fe0d3f547a66b91bfa05be01364f751a7466162b0c440760fc70a2f44d2e'}, {'image_id': 'rmhp-4-027f5', 'image_file_name': 'rmhp-4-027f5.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f5.jpg', 'caption': 'Sedillot’s triangle: sternal head of sternocleidomastoid (yellow arrow), clavicular head sternocleidomastoid (orange arrow), clavicle (red arrow); and position of appropriate cutaneous puncture at apex of triangle (black star).', 'hash': '5ddc93fa29007615ca9c6246355a180c3e1791dea20fd312df57b1d545ed131f'}, {'image_id': 'rmhp-4-027f2', 'image_file_name': 'rmhp-4-027f2.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f2.jpg', 'caption': 'Computed tomography scan showing venous course from right internal jugular vein (blue arrows) and venous course from left subclavian vein (yellow arrow) through the innominate vein (white arrow) to superior vena cava (orange arrow); course from left internal jugular vein (green arrow) with turns at junctions with innominate vein and superior vena cava.', 'hash': '0868e11bb3d66e23ea995105c63e038ce96afff71200395fc817d199469ae13d'}, {'image_id': 'rmhp-4-027f8', 'image_file_name': 'rmhp-4-027f8.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f8.jpg', 'caption': 'Ultrasound image of right internal jugular vein compressed by gentle probe pressure (white star) and carotid artery (yellow star).', 'hash': '6e32be38dac4831979453a660f7989b11dcbb7b6701dfb2ad4cc48ecf8f9ab82'}, {'image_id': 'rmhp-4-027f1', 'image_file_name': 'rmhp-4-027f1.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f1.jpg', 'caption': 'Long-term right internal jugular venous catheter (tip at orange arrow) appropriately positioned relative to right tracheobronchial angle (at yellow arrow).', 'hash': '5e8fc0966acb5f7397446d3d228caa0045ec1ebde672316e9426d31e58f2c46a'}, {'image_id': 'rmhp-4-027f6', 'image_file_name': 'rmhp-4-027f6.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f6.jpg', 'caption': 'External jugular vein crossing the posterior border of sternocleidomastoid (arrow), Sedillot’s triangle (red star), and sternal notch (black star).', 'hash': '5e18215a2bdfc58e9d55f6c6ceda6af65728cd4dac7f38ead3658f8003983237'}, {'image_id': 'rmhp-4-027f7', 'image_file_name': 'rmhp-4-027f7.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f7.jpg', 'caption': 'Ultrasound image of right carotid artery (yellow star) and right internal jugular vein (white star).', 'hash': '054b816a17d45f0984d0ad7b153ab7cf953404c89a972efd25120ab13913353c'}, {'image_id': 'rmhp-4-027f9', 'image_file_name': 'rmhp-4-027f9.jpg', 'image_path': '../data/media_files/PMC3270925/rmhp-4-027f9.jpg', 'caption': 'The “break” of the clavicle (arrow) and position of appropriate cutaneous puncture (black star). Note that head and neck drapes must always be placed with care to avoid potential airway obstruction and to allow appropriate airway assessment.', 'hash': '8e34292ac3fe18cc329e20b3b5000853a9d00ab24b75787b198e40a41082f5fe'}] | {'rmhp-4-027f1': ['Ideally the catheter tip lies at the junction of the superior vena cava and the right atrium. This location ensures a proximal position with high blood flow which prevents thrombosis (especially of concern with parenteral nutrition solutions and chemotherapeutic agents) and yet lies outside the atrium and thus prevents arrhythmias from catheter tip irritation of the right atrial wall. The surface landmark corresponding to this position is the angle of Louis, ie, the junction between the manubrium and the sternum. Measurement of the distance between the cutaneous puncture site and the angle of Louis along the trajectory of the vein allows the operator to estimate the appropriate length of catheter for insertion. Pikwer et al found catheter tip malposition, defined as extrathoracic or ventricular locations, in 3.3% of insertions; the highest incidence occurring from the right subclavian approach (9.1%) and the lowest from the right internal jugular approach (1.4%).10 The present authors consider distal intrathoracic and atrial locations to also represent malpositions, and thus the data of Pikwer et al may under-represent the incidence. An appropriate radiographic landmark to guide appropriate catheter tip position on chest x-ray is the right tracheobronchial angle, which is always inferior to the cephalad origin of the superior vena cava by a median distance of 1.5 cm; this landmark is always at least 2.9 cm superior to the atriocaval junction.11 Thus, catheter tips positioned approximately 3 cm below the right tracheobronchial angle will lie in close proximity to the atriocaval junction but will remain extracardiac in location (<xref ref-type="fig" rid="rmhp-4-027f1">Figure 1</xref>). Fluoroscopically-assisted measurements of guidewire length from the cutaneous puncture site to the superior vena cava-atrial junction have revealed mean distances of 16.0 cm for the right internal jugular, 18.4 cm for the right subclavian, 19.1 cm for the left internal jugular, and 21.2 cm for the left subclavian veins, respectively.). Fluoroscopically-assisted measurements of guidewire length from the cutaneous puncture site to the superior vena cava-atrial junction have revealed mean distances of 16.0 cm for the right internal jugular, 18.4 cm for the right subclavian, 19.1 cm for the left internal jugular, and 21.2 cm for the left subclavian veins, respectively.12 These measurements are useful guides, but long-term catheters should be positioned precisely under fluoroscopy, and the position of short-term lines should be confirmed with a postprocedure chest x-ray.'], 'rmhp-4-027f2': ['Large caliber catheters, such as dialysis catheters, are placed after the passage of a stiff dilator creates a subcutaneous tract. Soft silastic catheters for long-term use are too flimsy to be placed over a guidewire; they are placed through a peel-away introducer sheath which is itself placed while loaded onto an obturating dilator. These dilators, being wide-bore and stiff, cause serious injury to any structure unintentionally punctured. Vascular injury may lead to life-threatening hemorrhage or cardiac tamponade.13 The danger of vessel injury makes an understanding of the underlying vein trajectory critical. From the right internal jugular and left subclavian approaches, the veins respectively take straight and gently curving trajectories to the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). However, the right subclavian vein takes a near-right angle turn into the superior vena cava (). However, the right subclavian vein takes a near-right angle turn into the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f3">Figure 3</xref>), and the left internal jugular approach incorporates two turns, one into the brachiocephalic vein and a second into the superior vena cava (), and the left internal jugular approach incorporates two turns, one into the brachiocephalic vein and a second into the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). These turns create potential for the venous side walls to be punctured by a dilator failing to negotiate a curve appropriately.). These turns create potential for the venous side walls to be punctured by a dilator failing to negotiate a curve appropriately.', 'It is important to recognize that the deep courses of the left and right internal jugular veins are not bilaterally symmetric. The right internal jugular vein follows a direct course inferiorly to the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). The left internal jugular vein courses to the right after it joins the left subclavian vein to become the innominate vein, and the innominate vein subsequently courses inferiorly as it joins the superior vena cava (). The left internal jugular vein courses to the right after it joins the left subclavian vein to become the innominate vein, and the innominate vein subsequently courses inferiorly as it joins the superior vena cava (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). The angulation at the junction of the left internal jugular vein and innominate vein can create difficulties when passing catheters through introducer sheaths. First, the introducer sheath may become kinked as it negotiates this angle, preventing the passage of an intravascular catheter through the sheath. In this event, seen clinically during the passage of soft, long-term tunneled catheters through “peel-away” introducer sheaths, the introducer sheath must be partially withdrawn so that it will straighten and allow passage of the catheter; if the sheath becomes permanently crimped and narrowed, it must be exchanged for a new sheath inserted to a shallower intravenous depth. Alternatively, the tip of the introducer sheath may lie so close to the inferior wall of the innominate vein that the catheter kinks as it exits the introducer sheath. This latter situation will cause damping of pressures monitored through pulmonary artery or central venous pressure catheters, which can be rectified by partial withdrawal of the introducer. Finally, a stiff dilator inserted to a maximal depth has the potential to puncture the inferior wall of the innominate vein at the jugular-innominate junction. To prevent such complications, dilators should be inserted only far enough to dilate the subcutaneous tract as discussed earlier.). The angulation at the junction of the left internal jugular vein and innominate vein can create difficulties when passing catheters through introducer sheaths. First, the introducer sheath may become kinked as it negotiates this angle, preventing the passage of an intravascular catheter through the sheath. In this event, seen clinically during the passage of soft, long-term tunneled catheters through “peel-away” introducer sheaths, the introducer sheath must be partially withdrawn so that it will straighten and allow passage of the catheter; if the sheath becomes permanently crimped and narrowed, it must be exchanged for a new sheath inserted to a shallower intravenous depth. Alternatively, the tip of the introducer sheath may lie so close to the inferior wall of the innominate vein that the catheter kinks as it exits the introducer sheath. This latter situation will cause damping of pressures monitored through pulmonary artery or central venous pressure catheters, which can be rectified by partial withdrawal of the introducer. Finally, a stiff dilator inserted to a maximal depth has the potential to puncture the inferior wall of the innominate vein at the jugular-innominate junction. To prevent such complications, dilators should be inserted only far enough to dilate the subcutaneous tract as discussed earlier.', 'As with the internal jugular veins, the deep courses of the right and left subclavian veins are not bilaterally symmetric. The venous course from the left subclavian vein arcs through the innominate vein to the superior vena cava in a gentle curve (<xref ref-type="fig" rid="rmhp-4-027f2">Figure 2</xref>). However, the right subclavian vein makes a more sharply angled turn into the superior vena cava as it is joined by the internal jugular vein (). However, the right subclavian vein makes a more sharply angled turn into the superior vena cava as it is joined by the internal jugular vein (<xref ref-type="fig" rid="rmhp-4-027f3">Figure 3</xref>). This sharp angle of the right subclavian vein can lead to difficulties with placing catheters through introducer sheaths. If the introducer sheath lies too far medially relative to the lumen of the superior vena cava, lines may either kink as they pass into the superior vena cava or be passed into the contralateral subclavian and axillary veins. Related to the bilateral asymmetry, malpositioning of catheters into the contralateral subclavian or either internal jugular vein occurs more frequently from right than from left subclavian venous access.). This sharp angle of the right subclavian vein can lead to difficulties with placing catheters through introducer sheaths. If the introducer sheath lies too far medially relative to the lumen of the superior vena cava, lines may either kink as they pass into the superior vena cava or be passed into the contralateral subclavian and axillary veins. Related to the bilateral asymmetry, malpositioning of catheters into the contralateral subclavian or either internal jugular vein occurs more frequently from right than from left subclavian venous access.52'], 'rmhp-4-027f4': ['Relative advantages of real-time ultrasonographic localization are discussed below for each vessel. Given the superficial location of the central veins at the sites of venipuncture, a high frequency probe of 7.5 mHz creates optimal images. Ultrasound equipment can be easily used within a sterile field (<xref ref-type="fig" rid="rmhp-4-027f4">Figure 4</xref>). Ultrasound does not obviate the need for anatomic knowledge, so surface anatomic landmarks remain necessary for orientation of both cannulating needles and the ultrasound probe itself. However, ultrasound affords the operator an “inside view” of vascular anatomy and eliminates the total reliance on mind’s eye visualization of deep structures that was originally an inherent part of all percutaneous techniques. Real-time sonography provides a means to aim the cannulating needle directly toward the internal jugular, axillary, and femoral veins while avoiding puncture of the accompanying arteries. Needle guides which orient the needle within the field of view along the path of the ultrasound beam can facilitate venipuncture. Although subclavian cannulation remains a blind technique, the use of ultrasound has improved outcomes for internal jugular vein cannulation, and is considered a current standard of care for cannulation at this site.). Ultrasound does not obviate the need for anatomic knowledge, so surface anatomic landmarks remain necessary for orientation of both cannulating needles and the ultrasound probe itself. However, ultrasound affords the operator an “inside view” of vascular anatomy and eliminates the total reliance on mind’s eye visualization of deep structures that was originally an inherent part of all percutaneous techniques. Real-time sonography provides a means to aim the cannulating needle directly toward the internal jugular, axillary, and femoral veins while avoiding puncture of the accompanying arteries. Needle guides which orient the needle within the field of view along the path of the ultrasound beam can facilitate venipuncture. Although subclavian cannulation remains a blind technique, the use of ultrasound has improved outcomes for internal jugular vein cannulation, and is considered a current standard of care for cannulation at this site.14,15'], 'rmhp-4-027f5': ['There are three percutaneous approaches to the internal jugular vein, ie, anterior, central, and posterior. The authors’ preferred approach for internal jugular cannulation is the central approach. The essential surface anatomy is comprised of the borders of Sedillot’s triangle, the sternal head of the sternocleidomastoid muscle medially, the clavicular head of the sternocleidomastoid laterally, and the superior border of the medial third of the clavicle inferiorly (<xref ref-type="fig" rid="rmhp-4-027f5">Figure 5</xref>). For the awake supine patient, the borders of this triangle are accentuated by active head-raising. For the noncooperative or obese patient, the triangle is best defined by initial palpation of the trachea and then drawing the fingers laterally over the sternal head of the sternocleidomastoid into the depression of the triangle. Cannulation begins with cutaneous puncture at the superior apex of this triangle. The needle and syringe are angled 45° off a coronal plane, and the needle is advanced in a sagittal plane.). For the awake supine patient, the borders of this triangle are accentuated by active head-raising. For the noncooperative or obese patient, the triangle is best defined by initial palpation of the trachea and then drawing the fingers laterally over the sternal head of the sternocleidomastoid into the depression of the triangle. Cannulation begins with cutaneous puncture at the superior apex of this triangle. The needle and syringe are angled 45° off a coronal plane, and the needle is advanced in a sagittal plane.'], 'rmhp-4-027f6': ['To initiate the posterior approach, the needle is placed at the posterior border of the sternocleidomastoid muscle, at a point one-third of the way from the sternoclavicular joint to the mastoid process. The external jugular vein crosses the sternocleidomastoid muscle at this point and, when visible, serves as a useful landmark (<xref ref-type="fig" rid="rmhp-4-027f6">Figure 6</xref>). The needle is advanced toward the ipsilateral sternoclavicular joint at an angle of 30°–40° off the skin.). The needle is advanced toward the ipsilateral sternoclavicular joint at an angle of 30°–40° off the skin.16,19 The cutaneous puncture site for the anterior approach lies at the medial border of the sternocleidomastoid at the level of the cricoid cartilage. The needle tip should pass medial to the sternocleidomastoid directed 30°–45° posteriorly from a coronal plane and 15°–45° laterally from a sagittal plane.'], 'rmhp-4-027f7': ['Ultrasound imaging through Sedillot’s triangle will demonstrate the carotid artery and internal jugular vein as two sonolucent circles. The artery is recognized as the smaller diameter, noncompressible vessel with a visible pulsation (<xref ref-type="fig" rid="rmhp-4-027f7">Figure 7</xref>).).'], 'rmhp-4-027f8': ['Cervical vessel diameters have been measured by ultrasound for a variety of clinical correlations. Common carotid artery diameter is reliably less than 1 cm.28–31 Internal jugular vein diameter is generally greater than one 1 cm, 23,24,32 but may be smaller.21,33 Although the internal jugular vein may generally be differentiated from the common carotid artery by its larger diameter, the diameters of these vessels will rarely approximate each other, and therefore, the internal jugular vein and common carotid artery are most reliably differentiated by their compressibility and pulsation, respectively. The internal jugular vein is easily compressible; gentle pressure applied to the ultrasound probe will completely flatten the diameter of the internal jugular vein while leaving the diameter of the carotid artery unchanged (<xref ref-type="fig" rid="rmhp-4-027f8">Figure 8</xref>). The cannulating needle and/or tissue compression it causes as it is advanced beneath the cutaneous surface can be visualized in real time by ultrasound, allowing the ultrasound image to guide puncture of the internal jugular vein at a 12 o’clock position and avoid unintended puncture of other structures.). The cannulating needle and/or tissue compression it causes as it is advanced beneath the cutaneous surface can be visualized in real time by ultrasound, allowing the ultrasound image to guide puncture of the internal jugular vein at a 12 o’clock position and avoid unintended puncture of other structures.'], 'rmhp-4-027f9': ['The goal of subclavian venipuncture is to pass a needle inferior to the clavicle and superior to the first rib to access the subclavian vein as it courses over the first rib. The appropriate course for the needle passes immediately beneath the junction of the medial one-third and lateral two-thirds of the clavicle. This junction, ie, the “break” of the clavicle,42 is the point at which the anterior convexity of the medial clavicle transitions into an anterior concavity laterally (<xref ref-type="fig" rid="rmhp-4-027f9">Figure 9</xref>). The appropriate point for cutaneous puncture lies 1–2 cm inferior and lateral to the clavicular transition point (). The appropriate point for cutaneous puncture lies 1–2 cm inferior and lateral to the clavicular transition point (<xref ref-type="fig" rid="rmhp-4-027f9">Figure 9</xref>). Cutaneous puncture at this point facilitates passage of the needle inferior to the clavicle. A cutaneous puncture site closer to the clavicle creates difficulty maneuvering the needle beneath the clavicle. More medial cannulation may be impeded by calcification of the costoclavicular ligament. As the needle is advanced, it must remain absolutely parallel to the floor; if the needle is directed posteriorly to negotiate the clavicle, the risk of pneumothorax is greatly increased. Only gentle pressure from the operator’s nondominant thumb is necessary to depress the needle in a flat coronal plane beneath the clavicle if the correct cutaneous puncture site is chosen. As the needle is advanced from the cutaneous puncture site to a point beneath the clavicular transition point, its tip should be aimed just above the tip of the operator’s nondominant index finger placed in the sternal notch. The needle is advanced along this course passing through the subclavius muscle until the subclavian vein is accessed.). Cutaneous puncture at this point facilitates passage of the needle inferior to the clavicle. A cutaneous puncture site closer to the clavicle creates difficulty maneuvering the needle beneath the clavicle. More medial cannulation may be impeded by calcification of the costoclavicular ligament. As the needle is advanced, it must remain absolutely parallel to the floor; if the needle is directed posteriorly to negotiate the clavicle, the risk of pneumothorax is greatly increased. Only gentle pressure from the operator’s nondominant thumb is necessary to depress the needle in a flat coronal plane beneath the clavicle if the correct cutaneous puncture site is chosen. As the needle is advanced from the cutaneous puncture site to a point beneath the clavicular transition point, its tip should be aimed just above the tip of the operator’s nondominant index finger placed in the sternal notch. The needle is advanced along this course passing through the subclavius muscle until the subclavian vein is accessed.'], 'rmhp-4-027f10': ['Medial to the anterior scalene muscle and first rib, the posterior relationships of the subclavian vein are the phrenic nerve (as it swings medially off the muscle), the internal mammary artery, and the apical pleura. The subclavian artery arcs more superiorly here so the vein is primarily apposed to the pleura. Thus, a venipuncture needle advanced too deeply at this level will puncture the pleura and lung. Given the conical shape of the superior chest cavity, inferior (caudad) angulation of the probing needle places the needle on a shorter course to the pleura (either through or inferior to the vein) and increases the likelihood of pneumothorax. Advancing the needle perfectly horizontally in a coronal plane places the needle on a trajectory that maximizes an encounter with vein before pleura. Consequently, pneumothorax is avoided by keeping the needle and syringe absolutely parallel to the floor. If the operator lifts the needle and syringe off the chest wall, angling the needle tip more deeply, passage into the pleural space and lung becomes much more likely because the subclavian veins are immediately apposed to pleura posteriorly (<xref ref-type="fig" rid="rmhp-4-027f10">Figures 10</xref> and and <xref ref-type="fig" rid="rmhp-4-027f11">11</xref>). For this reason, chronic forward rotation of the shoulders which prevent a flat horizontal course for the cannulating needle is a relative contraindication to subclavian cannulation.). For this reason, chronic forward rotation of the shoulders which prevent a flat horizontal course for the cannulating needle is a relative contraindication to subclavian cannulation.']} | Anatomic considerations for central venous cannulation | [
"Internal jugular vein",
"cannulation",
"ultrasound",
"venipuncture"
] | Risk Manag Healthc Policy | 1302678000 | Central venous cannulation is a commonly performed procedure which facilitates resuscitation, nutritional support, and long-term vascular access. Mechanical complications most often occur during insertion and are intimately related to the anatomic relationship of the central veins. Working knowledge of surface and deep anatomy minimizes complications. Use of surface anatomic landmarks to orient the deep course of cannulating needle tracts appropriately comprises the crux of complication avoidance. The authors describe use of surface landmarks to facilitate safe placement of internal jugular, subclavian, and femoral venous catheters. The role of real-time sonography as a safety-enhancing adjunct is reviewed. | [] | other | PMC3270925 | null | 66 | [
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] | Risk Manag Healthc Policy. 2011 Apr 13; 4:27-39 | NO-CC CODE |
|
Time course of chest computed tomographic (CT) scan findings in a 50-year-old patient with COVID-19 (A–F, before discharge; G–I, after discharge; J–L, rehospitalized; and first column, axis scans; second column, coronal scans; third column, three-dimensional reconstruction). (C) Illness day 10 CT images revealed sporadic bilateral patchy ground-glass opacification with air bronchogram sign (orange arrows). Adjacent pleura was thickened without pleural fluid. (D–F) Illness day 16 (at hospital discharge) images showed increase of ground-glass opacities with a higher density and fiber stripes (blue arrows). (G–I) At 18 days' follow-up after discharge (illness day 34), reverse transcriptase PCR indicated positive again, while CT findings showed improvement of original lesion with a few ground-glass opacities (green arrows). (J–L) Thirteen days after rehospitalization (illness day 47); red arrows indicate further improvement of original lesions. | gr1_lrg | 7 | d90fd7283fa66de61f4fd2fc6c3c8b6f5bf00c7d6f48732593e9388b49eadd89 | gr1_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
787,
961
] | [{'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC7194898/gr1_lrg.jpg', 'caption': "Time course of chest computed tomographic (CT) scan findings in a 50-year-old patient with COVID-19 (A–F, before discharge; G–I, after discharge; J–L, rehospitalized; and first column, axis scans; second column, coronal scans; third column, three-dimensional reconstruction). (C) Illness day 10 CT images revealed sporadic bilateral patchy ground-glass opacification with air bronchogram sign (orange arrows). Adjacent pleura was thickened without pleural fluid. (D–F) Illness day 16 (at hospital discharge) images showed increase of ground-glass opacities with a higher density and fiber stripes (blue arrows). (G–I) At 18\xa0days' follow-up after discharge (illness day 34), reverse transcriptase PCR indicated positive again, while CT findings showed improvement of original lesion with a few ground-glass opacities (green arrows). (J–L) Thirteen days after rehospitalization (illness day 47); red arrows indicate further improvement of original lesions.", 'hash': 'd90fd7283fa66de61f4fd2fc6c3c8b6f5bf00c7d6f48732593e9388b49eadd89'}] | {'gr1_lrg': ['20. After hospital discharge, the patient was asked to continue the quarantine protocol at home for at least 2\xa0weeks. However, similar to what has been reported recently [2], this patient had two positive RT-PCR test results again on illness days 34 and 38 (postdischarge retesting was a policy of the Chinese government [1]). He was thus rehospitalized. This time he was asymptomatic, and his chest computed tomographic scans showed improvement of original lesions, with only a few ground-glass opacities (<xref rid="gr1_lrg" ref-type="fig">Fig.\xa01</xref>\n). We ran viral antibody tests on illness day 40 and got positive results (Innovita Biotechnology Company, Chengdu Precision Medicine Industrial Technology Research Institute, West China). The positive results of both immunoglobulin M and immunoglobulin G from this patient helped us confirm the diagnosis of SARS-CoV-2 infection [\n). We ran viral antibody tests on illness day 40 and got positive results (Innovita Biotechnology Company, Chengdu Precision Medicine Industrial Technology Research Institute, West China). The positive results of both immunoglobulin M and immunoglobulin G from this patient helped us confirm the diagnosis of SARS-CoV-2 infection [3]. He has been given further therapies, such as Chinese herbal medicines, to enhance his immunity until the RT-PCR result from nasopharyngeal swabs becomes consecutively negative twice at the time of discharge.Fig.\xa01Time course of chest computed tomographic (CT) scan findings in a 50-year-old patient with COVID-19 (A–F, before discharge; G–I, after discharge; J–L, rehospitalized; and first column, axis scans; second column, coronal scans; third column, three-dimensional reconstruction). (C) Illness day 10 CT images revealed sporadic bilateral patchy ground-glass opacification with air bronchogram sign (orange arrows). Adjacent pleura was thickened without pleural fluid. (D–F) Illness day 16 (at hospital discharge) images showed increase of ground-glass opacities with a higher density and fiber stripes (blue arrows). (G–I) At 18\xa0days\' follow-up after discharge (illness day 34), reverse transcriptase PCR indicated positive again, while CT findings showed improvement of original lesion with a few ground-glass opacities (green arrows). (J–L) Thirteen days after rehospitalization (illness day 47); red arrows indicate further improvement of original lesions.Fig.\xa01']} | SARS-CoV-2 positivity in a discharged COVID-19 patient: a case report | null | Clin Microbiol Infect | 1598684400 | International travel is increasing each year, and many travelers are female. Travel-related health risks include diseases, accidents, and other safety concerns. Whether traveling for business or pleasure, women should practice appropriate measures that minimize the impact travel can have on their health and well-being. Female travelers can have unique health risks related to pregnancy, lactation, and infectious disease. A large part of pretravel health preparation is often performed by nurses and should include a comprehensive health risk assessment, education, and vaccinations, all of which can help mitigate potential health risks for travelers. | [
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"Women's Health",
"Zika Virus",
"Zika Virus Infection"
] | other | PMC7194898 | null | 24 | [
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"{'Citation': 'World Health Organization International travel and health. 2012. http://www.who.int/ith/en Retrieved from.'}"
] | Clin Microbiol Infect. 2020 Aug 29; 26(8):1115-1117 | NO-CC CODE |
|
The initial CT images (F0) and three times of follow-up CT images (F1–F3) of P1. F0 showed patchy-like pure GGO located in the subpleural regions of the right middle lobe (F0, A3, arrow) and the right lower lobe, accompanied by crazy paving sign (F0, A2, arrowhead). Follow-up 1(F1, B1–B4): CT images showed diseases progression. The lesions manifested as coexisted nodular-like (F1, B4, arrow) and patchy-like lesions as well as peribronchial (F1, B2, arrowhead), central and subpleural distribution. The lesions are migratory manifested as the absorption of the primary lesions and the emergence of new lesions. CT images of Follow-up 2 (F2, C1–C4) and Follow-up 3 (F3, D1–D4) showed lesion absorption. | gr1_lrg | 7 | 3a6d523f4d01b798b91fc416e349ddc21106543c152b4dd49575e82406a18816 | gr1_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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"computerized tomography"
] | [
740,
523
] | [{'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC7194958/gr1_lrg.jpg', 'caption': 'The initial CT images (F0) and three times of follow-up CT images (F1–F3) of P1. F0 showed patchy-like pure GGO located in the subpleural regions of the right middle lobe (F0, A3, arrow) and the right lower lobe, accompanied by crazy paving sign (F0, A2, arrowhead). Follow-up 1(F1, B1–B4): CT images showed diseases progression. The lesions manifested as coexisted nodular-like (F1, B4, arrow) and patchy-like lesions as well as peribronchial (F1, B2, arrowhead), central and subpleural distribution. The lesions are migratory manifested as the absorption of the primary lesions and the emergence of new lesions. CT images of Follow-up 2 (F2, C1–C4) and Follow-up 3 (F3, D1–D4) showed lesion absorption.', 'hash': '3a6d523f4d01b798b91fc416e349ddc21106543c152b4dd49575e82406a18816'}, {'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC7194958/gr2_lrg.jpg', 'caption': 'The initial CT images of P2-P7. CT images of P2 (Fig. 2, P2, A1-A2), P5 (Fig. 2, P5), P6 (Fig. 2, P6, A1-A2) and P7 (Fig. 2, P7, A1–A4) showed subpleural lesions, a nodular-like lesion with pseudocavitary sign (Fig. 2, P7, A3, arrow) and mild bronchiectasis (Fig. 2, P6, A2, arrow) were also observed within the lesion. CT images of P3 (Fig. 2, P3, A1-A2) and P4 (Fig. 2, P4) showed round nodular-like GGO lesions (P3 and P4, arrow) located in the central area of the lung.', 'hash': '7941076c201f980146446ee98416feec1cd24f447831017534d16c810d838f7f'}, {'image_id': 'gr3_lrg', 'image_file_name': 'gr3_lrg.jpg', 'image_path': '../data/media_files/PMC7194958/gr3_lrg.jpg', 'caption': 'The initial CT images of P8-P11. CT images of P8 (Fig. 3, P8) and P9 (Fig. 3, P9) showed bilateral subpleural lesions with crazy paving sign. CT images of P10 (Fig. 3, P10, A1-A2) showed bilateral multiple lesions, some of them were pure GGO located in the central region of the lung. CT images of P11 (Fig. 3, P11, A1-A2) showed bilateral subpleural small nodular-like lesions.', 'hash': '3c7e54bd89c42b7a09b391b79acf765bcc6e24a8f93b319e932d41d14183b9d3'}] | {'gr1_lrg': ['On admission, 11 patients (P1–P11) underwent high resolution chest CT examination and their manifestations were shown in (Table 2\n). P1 (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F0, A1–A4): CT images showed patchy-like pure ground glass opacity (GGO) involving subpleural regions of the right middle lobe (, F0, A1–A4): CT images showed patchy-like pure ground glass opacity (GGO) involving subpleural regions of the right middle lobe (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F0, A3, arrow) and the right lower lobe. The slightly thickened interlobular septa within the lesion makes it appear the crazy paving sign (, F0, A3, arrow) and the right lower lobe. The slightly thickened interlobular septa within the lesion makes it appear the crazy paving sign (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F0, A2, arrowhead). P2 (, F0, A2, arrowhead). P2 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P2, A1-A2): CT images showed mixed GGO and consolidation that appeared at subpleural area of the right middle lobe and the right lower lobe. The lesion presented as patchy-like morphology. P3 (, P2, A1-A2): CT images showed mixed GGO and consolidation that appeared at subpleural area of the right middle lobe and the right lower lobe. The lesion presented as patchy-like morphology. P3 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P3, A1-A2): CT images showed two well circumscribed, round nodular-like GGO lesions (, P3, A1-A2): CT images showed two well circumscribed, round nodular-like GGO lesions (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P3, arrow) located in the central area of the left upper lobe. P4 (, P3, arrow) located in the central area of the left upper lobe. P4 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P4): CT images showed a small nodular-like pure GGO (, P4): CT images showed a small nodular-like pure GGO (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P4, arrow) located in the central area of the left lower lobe. P5 (, P4, arrow) located in the central area of the left lower lobe. P5 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P5): CT images showed a slight of irregular pure GGO (, P5): CT images showed a slight of irregular pure GGO (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P5, arrow) located in the subpleural region of the right lower lobe. P6 (, P5, arrow) located in the subpleural region of the right lower lobe. P6 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P6, A1-A2): CT images showed bilateral multi-focal mixed GGO and consolidation appeared at subpleural area of lung. Mild bronchiectasis (, P6, A1-A2): CT images showed bilateral multi-focal mixed GGO and consolidation appeared at subpleural area of lung. Mild bronchiectasis (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P6, A2, arrow) can also be observed within the lesion. P7 (, P6, A2, arrow) can also be observed within the lesion. P7 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P7, A1–A4): CT images showed bilateral subpleural lesions, among which the lesion in the left lower lobe was nodular-like with pseudocavitary sign (, P7, A1–A4): CT images showed bilateral subpleural lesions, among which the lesion in the left lower lobe was nodular-like with pseudocavitary sign (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P7, A3, arrow). P8 (, P7, A3, arrow). P8 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P8) and P9 (, P8) and P9 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P9): CT images showed bilateral subpleural lesions with crazy paving sign. P10 (, P9): CT images showed bilateral subpleural lesions with crazy paving sign. P10 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P10, A1-A2): CT images showed bilateral multiple lesions, some of them were pure GGO located in the central region of the lung. P11 (, P10, A1-A2): CT images showed bilateral multiple lesions, some of them were pure GGO located in the central region of the lung. P11 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P11, A1-A2): CT images showed bilateral subpleural small nodular-like lesions., P11, A1-A2): CT images showed bilateral subpleural small nodular-like lesions.Table 2Imaging characteristics during the first visit.Table 2Imaging characteristicsP1P2P3P4P5P6P7P8P9P10P11Lobar location\xa0RUL√√√√\xa0RML√√√√\xa0RLL√√√√√√√√√\xa0LUL√√√√\xa0LLL√√√√√√Distribution\xa0Subpleural√√√√√√√√\xa0Random or diffuse√√√Morphology\xa0Patchy-like√√√√√√\xa0Nodular-like√√√\xa0Both√√Contour\xa0Clear√√√\xa0Blurry√√√√√√√√Attenuation\xa0GGO only√√√√√\xa0Mixed GGO and consolidation√√√√√√Consolidation onlyOther signs\xa0Reticulation√\xa0crazy paving√√√√\xa0Cavitation\xa0Bronchiectasis√\xa0Pleural effusion\xa0LymphadenopathyAbbreviations: RUL-right upper lobe, RML-right middle lobe; RLL-right lower lobe, LUL-left upper lobe, LLL-left lower lobe; GGO, ground glass opacity. "P#" represents one patient. Note: Check mark (√) indicate the appearance of the corresponding sign.Fig. 1The initial CT images (F0) and three times of follow-up CT images (F1–F3) of P1. F0 showed patchy-like pure GGO located in the subpleural regions of the right middle lobe (F0, A3, arrow) and the right lower lobe, accompanied by crazy paving sign (F0, A2, arrowhead). Follow-up 1(F1, B1–B4): CT images showed diseases progression. The lesions manifested as coexisted nodular-like (F1, B4, arrow) and patchy-like lesions as well as peribronchial (F1, B2, arrowhead), central and subpleural distribution. The lesions are migratory manifested as the absorption of the primary lesions and the emergence of new lesions. CT images of Follow-up 2 (F2, C1–C4) and Follow-up 3 (F3, D1–D4) showed lesion absorption.Fig. 1Fig. 2The initial CT images of P2-P7. CT images of P2 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P2, A1-A2), P5 (, P2, A1-A2), P5 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P5), P6 (, P5), P6 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P6, A1-A2) and P7 (, P6, A1-A2) and P7 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P7, A1–A4) showed subpleural lesions, a nodular-like lesion with pseudocavitary sign (, P7, A1–A4) showed subpleural lesions, a nodular-like lesion with pseudocavitary sign (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P7, A3, arrow) and mild bronchiectasis (, P7, A3, arrow) and mild bronchiectasis (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P6, A2, arrow) were also observed within the lesion. CT images of P3 (, P6, A2, arrow) were also observed within the lesion. CT images of P3 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P3, A1-A2) and P4 (, P3, A1-A2) and P4 (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>, P4) showed round nodular-like GGO lesions (P3 and P4, arrow) located in the central area of the lung., P4) showed round nodular-like GGO lesions (P3 and P4, arrow) located in the central area of the lung.Fig. 2Fig. 3The initial CT images of P8-P11. CT images of P8 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P8) and P9 (, P8) and P9 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P9) showed bilateral subpleural lesions with crazy paving sign. CT images of P10 (, P9) showed bilateral subpleural lesions with crazy paving sign. CT images of P10 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P10, A1-A2) showed bilateral multiple lesions, some of them were pure GGO located in the central region of the lung. CT images of P11 (, P10, A1-A2) showed bilateral multiple lesions, some of them were pure GGO located in the central region of the lung. CT images of P11 (<xref rid="gr3_lrg" ref-type="fig">Fig. 3</xref>, P11, A1-A2) showed bilateral subpleural small nodular-like lesions., P11, A1-A2) showed bilateral subpleural small nodular-like lesions.Fig. 3', 'P1 had three follow-up CTs (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F1–F3). The time interval between initial chest CT and follow-up were 4, 8, 14 days. Follow-up 1(, F1–F3). The time interval between initial chest CT and follow-up were 4, 8, 14 days. Follow-up 1(<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F1, B1–B4): CT images showed diseases progression. The lesions showed diversified morphology and distribution, appearing as coexisted nodular-like (, F1, B1–B4): CT images showed diseases progression. The lesions showed diversified morphology and distribution, appearing as coexisted nodular-like (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F1, B4, arrow) and patchy-like lesions as well as peribronchial (, F1, B4, arrow) and patchy-like lesions as well as peribronchial (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F1, B2, arrowhead), central and subpleural distribution. CT images of F1 showed the that lesions were migratory manifested as the absorption of the primary lesions and the emergence of new lesions. CT images of Follow-up 2 (, F1, B2, arrowhead), central and subpleural distribution. CT images of F1 showed the that lesions were migratory manifested as the absorption of the primary lesions and the emergence of new lesions. CT images of Follow-up 2 (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F2, C1-C4) and Follow-up 3 (, F2, C1-C4) and Follow-up 3 (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, F3, D1–D4) showed the diseases were obviously absorbed., F3, D1–D4) showed the diseases were obviously absorbed.']} | Clinical and CT imaging features of 2019 novel coronavirus disease (COVID-19) | null | J Infect | 1594191600 | [] | other | PMC7194958 | null | 5 | [
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] | J Infect. 2020 Jul 8; 81(1):147-178 | NO-CC CODE |
||
(A) CT angiogram showing filling defects within the right middle lobe, right lower lobe, and left lower lobe segmental and sub-segmental branches suggestive of extensive segmental pulmonary emboli (red arrows). Small filling defects are also seen within the left upper lobe sub segmental branches. (B) Peripheral ground glass opacities in the right middle and lower lobes are suggestive of pulmonary infarcts (red arrow). | amjcaserep-16-606-g001 | 7 | e1c6cf1bc846ffdcaf042cb504914ae211335fb784db0aa71eff48c7d22772f4 | amjcaserep-16-606-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
946
] | [{'image_id': 'amjcaserep-16-606-g002', 'image_file_name': 'amjcaserep-16-606-g002.jpg', 'image_path': '../data/media_files/PMC4572719/amjcaserep-16-606-g002.jpg', 'caption': 'Large left psoas abscess (black arrow).The left common iliac artery (red arrow) and left common iliac veinwith a thrombus in the lumen (blue arrow) are being compressed by the large psoas abscess (compare with vessels on right side). There is fluid centered around the vertebral body with sclerotic changes and endplate erosions, suggestive of osteomyelitis and discitis.', 'hash': '603e9476677b33eb71b433cb4dce8313e3fd849dd5f3aba2fb7907b94acb7029'}, {'image_id': 'amjcaserep-16-606-g001', 'image_file_name': 'amjcaserep-16-606-g001.jpg', 'image_path': '../data/media_files/PMC4572719/amjcaserep-16-606-g001.jpg', 'caption': '(A) CT angiogram showing filling defects within the right middle lobe, right lower lobe, and left lower lobe segmental and sub-segmental branches suggestive of extensive segmental pulmonary emboli (red arrows). Small filling defects are also seen within the left upper lobe sub segmental branches. (B) Peripheral ground glass opacities in the right middle and lower lobes are suggestive of pulmonary infarcts (red arrow).', 'hash': 'e1c6cf1bc846ffdcaf042cb504914ae211335fb784db0aa71eff48c7d22772f4'}] | {'amjcaserep-16-606-g001': ['He developed a fever of 102°F on day 1 of admission and was started on intravenous (IV) Ceftriaxone and Azithromycin with the suspicion of community-acquired pneumonia. Because of the presence of an elevated D-dimer assay and sinus tachycardia on his admission electrocardiogram, a CT angiogram of his chest was ordered in the emergency room. It showed extensive segmental and sub segmental PE bilaterally with peripheral ground glass opacities in the right middle and lower lobes, suggestive of a pulmonary infarct (<xref ref-type="fig" rid="amjcaserep-16-606-g001">Figure 1A</xref>, , <xref ref-type="fig" rid="amjcaserep-16-606-g001">1B</xref>). To establish the etiology of PE, ultrasound of the lower extremities was done, which showed an acute deep venous thrombosis (DVT) involving the left common femoral vein down to the level of the left popliteal vein. The patient was admitted to the intensive care unit (ICU) and was started on IV unfractionated heparin. He continued to be febrile in the ICU and because of his flank pain and history of psoas abscess in the past, a CT of his abdomen and pelvis with contrast was done, which showed very large multiloculated, septated, bilateral retroperitoneal, primarily psoas, abscesses as well as findings in the lower lumbar spine worrisome for osteomyelitis and discitis from L3 to S1. Moreover, the left-sided abscess was pressing on the left common iliac vein (). To establish the etiology of PE, ultrasound of the lower extremities was done, which showed an acute deep venous thrombosis (DVT) involving the left common femoral vein down to the level of the left popliteal vein. The patient was admitted to the intensive care unit (ICU) and was started on IV unfractionated heparin. He continued to be febrile in the ICU and because of his flank pain and history of psoas abscess in the past, a CT of his abdomen and pelvis with contrast was done, which showed very large multiloculated, septated, bilateral retroperitoneal, primarily psoas, abscesses as well as findings in the lower lumbar spine worrisome for osteomyelitis and discitis from L3 to S1. Moreover, the left-sided abscess was pressing on the left common iliac vein (<xref ref-type="fig" rid="amjcaserep-16-606-g002">Figure 2</xref>), resulting in its occlusion and distal thrombus formation. Antibiotics were changed to IV vancomycin and IV piperacillin-tazobactam. Given his previous bacteremia, an echocardiogram was done, which showed no vegetations. Osteomyelitis of L3 to S1 was confirmed by the contrast-enhanced magnetic resonance imaging (MRI) of the lumbar spine.), resulting in its occlusion and distal thrombus formation. Antibiotics were changed to IV vancomycin and IV piperacillin-tazobactam. Given his previous bacteremia, an echocardiogram was done, which showed no vegetations. Osteomyelitis of L3 to S1 was confirmed by the contrast-enhanced magnetic resonance imaging (MRI) of the lumbar spine.']} | Unusual Presentation of Recurrent Pyogenic Bilateral Psoas Abscess Causing Bilateral Pulmonary Embolism by Iliac Vein Compression | [
"Psoas Abscess",
"Pulmonary Embolism",
"Venous Thrombosis"
] | Am J Case Rep | 1441868400 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'The clinical conditions of various diseases, including coronary artery disease, are determined by genetics and the environment. Previous investigations noted the significance of genetic mutations and polymorphisms in cases of coronary spasm.'}, {'@Label': 'CASE REPORT', '@NlmCategory': 'METHODS', '#text': 'We report on monozygotic identical twins who almost simultaneously presented with vasospastic angina. The 58-year-old younger twin was admitted to our hospital because of persistent chest pain. An electrocardiogram showed an inverted T wave in the left precordial leads. Coronary angiographies revealed a short left main trunk (LMT) and 50% stenosis at the proximal portion of the left anterior descending artery (LAD). Infusion of acetylcholine to his left coronary artery caused marked vasoconstriction associated with a sensation of chest oppression. Nitroglycerine completely reversed this response. Based on these findings, we diagnosed Twin A with vasospastic angina. At nearly the same time, his identical twin brother was diagnosed with vasospastic angina at another hospital. Comparison of both coronary angiograms indicated similar structure of coronary vessels, including short LMT and mild stenosis at the proximal portion of LAD.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'These 2 cases highlight the importance of genetic factors in the pathogenesis of vasospastic angina. It may be important for individuals to receive medical attention if their identical twin presents with vasospastic angina.'}] | [
"Angina Pectoris",
"Coronary Vasospasm",
"Diseases in Twins",
"Humans",
"Male",
"Middle Aged",
"Twins, Monozygotic"
] | other | PMC4572719 | null | 17 | [
"{'Citation': 'Yoshimura M, Yasue H, Nakayama M, et al. A missense Glu298Asp variant in the endothelial nitric oxide synthase gene is associated with coronary spasm in the Japanese. Hum Genet. 1998;103:65–69.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9737779'}}}",
"{'Citation': 'Nakayama M, Yasue H, Yoshimura M, et al. T-786-->C mutation in the 5′-flanking region of the endothelial nitric oxide synthase gene is associated with coronary spasm. Circulation. 1999;99:2864–70.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10359729'}}}",
"{'Citation': 'Nakano T, Osanai T, Tomita H, et al. Enhanced activity of variant phospholipase C-delta1 protein (R257H) detected in patients with coronary artery spasm. Circulation. 2002;105:2024–29.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11980680'}}}",
"{'Citation': 'Okumura K, Osanai T, Kosugi T, et al. Enhanced phospholipase C activity in the cultured skin fibroblast obtained from patients with coronary spastic angina: possible role for enhanced vasoconstrictor response. J Am Coll Cardiol. 2000;36:1847–52.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11092655'}}}",
"{'Citation': 'Shibutani S, Osanai T, Ashitate T, et al. Coronary vasospasm induced in transgenic mouse with increased phospholipase C-δ1 activity. Circulation. 2012;125:1027–36.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22265909'}}}",
"{'Citation': 'Murase Y, Yamada Y, Hirashiki A, et al. Genetic risk and gene-environment interaction in coronary artery spasm in Japanese men and women. Eur Heart J. 2004;25:970–77.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15172469'}}}",
"{'Citation': 'Cokkinos P, Sbarouni E. Coronary angioplasty in identical twins. Int J Cardiol. 2006;107:434–35.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16503274'}}}",
"{'Citation': 'Rizik DG, Dowler DA, Villegas BJ. Identical twins, identical coronary disease. J Invasive Cardiol. 2005;17(12):677–79.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16327053'}}}",
"{'Citation': 'Turley AJ, Chen V, Hall JA. Simultaneous presentation of coronary heart disease in identical twins. Postgrad Med J. 2008;84:100–2.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18322132'}}}",
"{'Citation': 'Nathoe HMW, Stella PR, Eefting FD, de Jaegere PP. Angiographic finfings in monozygotic twins with coronary artery disease. Am J Cardiol. 2002;89:1006–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11950451'}}}",
"{'Citation': 'Samuels LE, Samuels FS, Thomas MP, Morris RJ, Wechsler AS. Coronary artery disease in identical twins. Ann Thorac Surg. 1999;68:594–600.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10475448'}}}",
"{'Citation': 'Tachibana K, Kazatani Y, Kodama K, et al. Vasospastic Angina in two sisters. Jpn Heart J. 1995;36:669–73.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8558771'}}}",
"{'Citation': 'Fujiwara Y, Yamanaka O, Nakamura T, Yamaguchi H. Coronary spasm in two sisters. Jpn Circ J. 1993;57:472–74.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8510317'}}}",
"{'Citation': 'Machii N, Ishida G, Mizukami H, et al. [Vasospastic angina in identical twins] Nihon Naika Gakkai Zasshi. 2007;96:2798–800. [in Japanese]', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18203418'}}}",
"{'Citation': 'Zdravkovic S, Wienke A, Pedersen NL, de Faire U. Genetic influences on angina pectoris and its impact on coronary heart disease. Eur J Hum Genet. 2007;15:872–77.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17487220'}}}",
"{'Citation': 'Zdravkovic S, Wienke A, Pedersen NL, et al. Genetic influences on CHD-death and the impact of known risk factors: comparison of two frailty models. Behav Genet. 2004;34:585–92.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15520515'}}}",
"{'Citation': 'Deloukas P, Kanoni S, Willenborg C, et al. Large-scale association analysis identifies new risk loci for coronary artery disease. Nat Genet. 2012;45:25–33.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3679547'}, {'@IdType': 'pubmed', '#text': '23202125'}]}}"
] | Am J Case Rep. 2015 Sep 10; 16:606-610 | NO-CC CODE |
|
A 70-year- old male investigated for recurrence-residue. Glottic and subglottic suspicious masses were seen (false positive) with CT (A). Dynamic MRI (B) and PET/CT (C) were clear for a mass. | poljradiol-80-428-g002 | 7 | b0ab5e75cd279ed914f6504b9f156c85a5aec4c2ad2f6f54e0347c9d7c14bf32 | poljradiol-80-428-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
780,
268
] | [{'image_id': 'poljradiol-80-428-g002', 'image_file_name': 'poljradiol-80-428-g002.jpg', 'image_path': '../data/media_files/PMC4577024/poljradiol-80-428-g002.jpg', 'caption': 'A 70-year- old male investigated for recurrence-residue. Glottic and subglottic suspicious masses were seen (false positive) with CT (A). Dynamic MRI (B) and PET/CT (C) were clear for a mass.', 'hash': 'b0ab5e75cd279ed914f6504b9f156c85a5aec4c2ad2f6f54e0347c9d7c14bf32'}, {'image_id': 'poljradiol-80-428-g001', 'image_file_name': 'poljradiol-80-428-g001.jpg', 'image_path': '../data/media_files/PMC4577024/poljradiol-80-428-g001.jpg', 'caption': 'A 61-year- old male investigated for recurrence-residue. CT (A) and dynamic MRI (B) have a false -negative result. Glottic and subglottic masses (arrow) were seen with PET/CT (C). Histopathological examination revealed squamous cell carcinoma.', 'hash': '9fd7c783f95584107688534ed40d46b0474a499ca20fe59dc983dbecce7c0b9a'}] | {'poljradiol-80-428-g001': ['As regards the mass size, 5 (25%) lesions were larger than 2 cm, 6 (30%) were smaller than 1 cm and 9 (45%) were 1–2 cm. MRI and PET/CT changed the diagnosis of CT in 67% of patients where the mass was smaller than 1 cm and in 44%,and 50% in 1–2-cm masses, respectively. There was no diagnostic change of masses larger than 2 cm. MRI and PET/CT provide 100% true results in masses smaller than 1 cm and 80% and, 100% in 1–2-cm masses which had false results with CT, respectively. In the evaluation of recurrence and residual tissue, sensitivity, specificity, and accuracy were 86%, 67% and 80% with MRI and 100% for all parameters with PET/CT. MRI and PET/CT provided 83%- and 100%- true diagnosis, respectively, which were false- positive or false- negative with CT (<xref ref-type="fig" rid="poljradiol-80-428-g001">Figures 1</xref>, , <xref ref-type="fig" rid="poljradiol-80-428-g002">2</xref>).).']} | Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results | [
"Laryngeal Neoplasms",
"Magnetic Resonance Imaging",
"Tomography, Emission-Computed"
] | Pol J Radiol | 1442127600 | Study Design Case report and review of the literature. Objective To report a unique case of an intraspinal chondrosarcoma that was diagnosed 18 years after radiotherapy for a cervical carcinoma and its remarkably unusual clinical presentation. Methods A retrospective case description of an intraspinal mass lesion that occurred 6 weeks after previous spinal surgery. Results Within ∼9 weeks, the tumor had infiltrated the peritoneal cavity and reached the lumbar subcutaneous tissue. Conclusion Radiation-induced sarcomas are rare, are highly aggressive, and may be difficult to diagnose. Furthermore, the only means of achieving long-term survival is through early and extensive surgery. | [] | other | PMC4577024 | null | 21 | [
"{'Citation': 'Rümenapp C, Smida J, Gonzalez-Vasconcellos I. et al.Secondary radiation-induced bone tumours demonstrate a high degree of genomic instability predictive of a poor prognosis. Curr Genomics. 2012;13(6):433–437.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3426777'}, {'@IdType': 'pubmed', '#text': '23450216'}]}}",
"{'Citation': 'Chmelevsky D, Kellerer A M, Land C E, Mays C W, Spiess H. Time and dose dependency of bone-sarcomas in patients injected with radium-224. Radiat Environ Biophys. 1988;27(2):103–114.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3164868'}}}",
"{'Citation': 'Spiess H, Mays C W. Bone cancers induced by 224 Ra (Th X) in children and adults. Health Phys. 1970;19(6):713–729.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '4935546'}}}",
"{'Citation': 'Walton A, Broadbent A L. Radiation-induced second malignancies. J Palliat Med. 2008;11(10):1345–1352.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19115898'}}}",
"{'Citation': 'Wiklund T A, Blomqvist C P, Räty J, Elomaa I, Rissanen P, Miettinen M. Postirradiation sarcoma. Analysis of a nationwide cancer registry material. Cancer. 1991;68(3):524–531.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2065271'}}}",
"{'Citation': 'Phillips T L, Sheline G E. Bone sarcomas following radiation therapy. Radiology. 1963;81:992–996.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14101725'}}}",
"{'Citation': 'Mark R J, Poen J, Tran L M, Fu Y S, Heaps J, Parker R G. Postirradiation sarcoma of the gynecologic tract. A report of 13 cases and a discussion of the risk of radiation-induced gynecologic malignancies. Am J Clin Oncol. 1996;19(1):59–64.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8554038'}}}",
"{'Citation': 'Amendola B E, Amendola M A, McClatchey K D, Miller C H Jr. Radiation-associated sarcoma: a review of 23 patients with postradiation sarcoma over a 50-year period. Am J Clin Oncol. 1989;12(5):411–415.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '2508462'}}}",
"{'Citation': 'Huvos A G, Woodard H Q, Heilweil M. Postradiation malignant fibrous histiocytoma of bone. A clinicopathologic study of 20 patients. Am J Surg Pathol. 1986;10(1):9–18.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3006524'}}}",
"{'Citation': 'Huvos A G, Woodard H Q, Cahan W G. et al.Postradiation osteogenic sarcoma of bone and soft tissues. A clinicopathologic study of 66 patients. Cancer. 1985;55(6):1244–1255.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3855683'}}}",
"{'Citation': 'Souba W W, McKenna R J Jr, Meis J, Benjamin R, Raymond A K, Mountain C F. Radiation-induced sarcomas of the chest wall. Cancer. 1986;57(3):610–615.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3942997'}}}",
"{'Citation': 'Murray E M, Werner D, Greeff E A, Taylor D A. Postradiation sarcomas: 20 cases and a literature review. Int J Radiat Oncol Biol Phys. 1999;45(4):951–961.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10571202'}}}",
"{'Citation': 'Lagrange J L, Ramaioli A, Chateau M C. et al.Sarcoma after radiation therapy: retrospective multiinstitutional study of 80 histologically confirmed cases. Radiology. 2000;216(1):197–205.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10887248'}}}",
"{'Citation': 'Mark R J, Poen J, Tran L M, Fu Y S, Selch M T, Parker R G. Postirradiation sarcomas. A single-institution study and review of the literature. Cancer. 1994;73(10):2653–2662.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8174066'}}}",
"{'Citation': 'Buis B, Spiro I. Post-irradiation sarcoma: history, outcome and determinants of outcome (abstract) Int J Radiat Oncol Biol Phys. 1998;42 01:193.'}",
"{'Citation': 'Chapelier A R, Bacha E A, de Montpreville V T. et al.Radical resection of radiation-induced sarcoma of the chest wall: report of 15 cases. Ann Thorac Surg. 1997;63(1):214–219.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8993268'}}}",
"{'Citation': 'Pitcher M E, Davidson T I, Fisher C, Thomas J M. Post irradiation sarcoma of soft tissue and bone. Eur J Surg Oncol. 1994;20(1):53–56.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8131870'}}}",
"{'Citation': 'Bloechle C, Peiper M, Schwarz R, Schroeder S, Zornig C. Post-irradiation soft tissue sarcoma. Eur J Cancer. 1995;31A(1):31–34.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7695975'}}}",
"{'Citation': 'Bobin J Y, Rivoire M, Delay E. et al.Radiation induced sarcomas following treatment for breast cancer: presentation of a series of 14 cases treated with an aggressive surgical approach. J Surg Oncol. 1994;57(3):171–177.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7967606'}}}",
"{'Citation': 'Clair D G, Lautz D B, Brooks D C. Rapid development of umbilical metastases after laparoscopic cholecystectomy for unsuspected gallbladder carcinoma. Surgery. 1993;113(3):355–358.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7772085'}}}",
"{'Citation': 'Demicheli R, Retsky M W, Hrushesky W J, Baum M, Gukas I D. The effects of surgery on tumor growth: a century of investigations. Ann Oncol. 2008;19(11):1821–1828.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18550576'}}}"
] | Pol J Radiol. 2015 Sep 13; 80:428-432 | NO-CC CODE |
|
(A) Sagittal T1-weighted post–gadolinium contrast cervical magnetic resonance image (MRI) noting a heterogeneously enhancing intramedullary astrocytoma (arrow). (B) Sagittal T2-weighted cervical MRI demonstrating an intramedullary astrocytoma (arrow). (C) Axial T1-weighted post–gadolinium contrast cervical MRI illustrating a cystic astrocytoma; the cystic portions are highlighted by arrows and are hypointense compared with the enhancing surrounding rim. | 10-1055-s-0035-1549029-i1400020-1 | 7 | 8b1afc4f98b095440300fa2479df1f2367cb40ed05fe1d04ac66ac655bc00d13 | 10-1055-s-0035-1549029-i1400020-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
476,
800
] | [{'image_id': '10-1055-s-0035-1549029-i1400020-1', 'image_file_name': '10-1055-s-0035-1549029-i1400020-1.jpg', 'image_path': '../data/media_files/PMC4577312/10-1055-s-0035-1549029-i1400020-1.jpg', 'caption': '(A) Sagittal T1-weighted post–gadolinium contrast cervical magnetic resonance image (MRI) noting a heterogeneously enhancing intramedullary astrocytoma (arrow). (B) Sagittal T2-weighted cervical MRI demonstrating an intramedullary astrocytoma (arrow). (C) Axial T1-weighted post–gadolinium contrast cervical MRI illustrating a cystic astrocytoma; the cystic portions are highlighted by arrows and are hypointense compared with the enhancing surrounding rim.', 'hash': '8b1afc4f98b095440300fa2479df1f2367cb40ed05fe1d04ac66ac655bc00d13'}, {'image_id': '10-1055-s-0035-1549029-i1400020-4', 'image_file_name': '10-1055-s-0035-1549029-i1400020-4.jpg', 'image_path': '../data/media_files/PMC4577312/10-1055-s-0035-1549029-i1400020-4.jpg', 'caption': '(A) Sagittal T1-weighted post–gadolinium contrast magnetic resonance image noting an avidly homogenous enhancing nodule representing a hemangioblastoma at the level of T2–T3 (arrow). (B) Corresponding axial view noting the involvement of the tumor in relation to the cord (arrow).', 'hash': 'caa6f38d0538e6dfc077c17bf0c6bf814963dcd841b6de1eb4730948087e0469'}, {'image_id': '10-1055-s-0035-1549029-i1400020-3', 'image_file_name': '10-1055-s-0035-1549029-i1400020-3.jpg', 'image_path': '../data/media_files/PMC4577312/10-1055-s-0035-1549029-i1400020-3.jpg', 'caption': 'Sagittal T1-weighted post–gadolinium contrast lumbar magnetic resonance image illustrating the presence of a homogenously enhancing ependymoma at the levels of L1 and L2 (arrow).', 'hash': 'f8f0b50ca5185a04ccb93461fcc5ebc6b6b41e73f2ac2b4e6fcd16ef549ccc56'}, {'image_id': '10-1055-s-0035-1549029-i1400020-2', 'image_file_name': '10-1055-s-0035-1549029-i1400020-2.jpg', 'image_path': '../data/media_files/PMC4577312/10-1055-s-0035-1549029-i1400020-2.jpg', 'caption': '(A) Sagittal T1-weighted post–gadolinium contrast cervical magnetic resonance image illustrating the presence of a homogeneously enhancing ependymoma at the levels of C5 and C6 (arrow). (B) Corresponding axial view noting the centromedullary location of the ependymoma (arrow).', 'hash': '2872a0f61d60656afb1f18bf419f0347540ce0fb819cf7247d26a76fc7ec73ae'}] | {'10-1055-s-0035-1549029-i1400020-1': ['Astrocytomas are red, gray, glossy tumors that are characterized by a poorly defined plane and are generally infiltrative in nature. Astrocytomas are the second most common IMSCT in adults at 30 to 35% of tumors and the most common in children at 90% of tumors.1\n10\n39 Of all astrocytomas arising in the CNS, 3% occur in the spinal cord.40 They primarily occur in the cervical spine, and they often involve multiple spinal segments due to the expansive nature of these tumors (<xref rid="10-1055-s-0035-1549029-i1400020-1" ref-type="fig">Fig. 1</xref>). Nearly 20% of such lesions are associated with syrinx formation.). Nearly 20% of such lesions are associated with syrinx formation.29 Astrocytomas have an association with NF-1, occur predominantly in males, and rarely manifest in patients over the age of 60.41 Adults mainly exhibit high-grade lesions, whereas low-grade lesions are associated with the younger population.42 Malignant degeneration develops in 25% of adult astrocytomas.43\n'], '10-1055-s-0035-1549029-i1400020-2': ['Ependymomas are soft, encapsulated, reddish gray or yellow tumors with modest vascularity that present in the third or fourth decade of life. Half of all ependymomas are located in the region spine and a slight majority are located in the cord (55%), relative to the cauda equina (45%).1 They are not sex discriminant.44\n45 The majority of them are classified as benign tumors, and ependymomas have a propensity to grow slowly. Spinal ependymomas are primarily present in the cervical or cervicothoracic region.46\n47 The cysts associated with these tumors are predominantly found in the superior margin of the tumor and have an increased incidence in the cervical region (<xref rid="10-1055-s-0035-1549029-i1400020-2" ref-type="fig">Fig. 2A</xref>).).29\n43\n48 Approximately 65% of these tumors are associated with syrinx formation.29\n', 'Originating from ependymal cells, ependymomas are more centromedullary located as compared with astrocytomas, and they tend to blend with the cord (<xref rid="10-1055-s-0035-1549029-i1400020-2" ref-type="fig">Fig. 2B</xref>). They appear as a focal enlargement within the spinal cord. Ependymomas have a mean extension of three to four vertebral bodies, whereas astrocytomas average five to six segmental levels.). They appear as a focal enlargement within the spinal cord. Ependymomas have a mean extension of three to four vertebral bodies, whereas astrocytomas average five to six segmental levels.49 Abnormalities of chromosome 22 are associated with ependymomas, and this leads to their association with NF-2.19 Various histologic subtypes of ependymomas exist. The most common is the cellular variant or the “typical” form, which is a World Health Organization (WHO) grade II tumor that is well circumscribed. Pathologic analysis reveals both true ependymal rosettes and more commonly perivascular pseudorosettes.50 Tanycytic ependymomas are also WHO grade II, are less common overall, and are found more commonly in the spinal cord than in the brain. Histologically, tanycytic ependymomas lack ependymal rosettes and their pseudorosettes are vaguely apparent, which can lead to misdiagnosis as pilocytic astrocytoma (WHO grade I).19 Myxopapillary ependymomas are WHO grade I tumors commonly found at the filum terminale, but these are considered extramedullary (<xref rid="10-1055-s-0035-1549029-i1400020-3" ref-type="fig">Fig. 3</xref>). Rarely anaplastic ependymomas, WHO grade III, can be encountered, which develop more rapidly than lower grades, can occasionally develop from malignant degeneration, and have an overall poor prognosis.). Rarely anaplastic ependymomas, WHO grade III, can be encountered, which develop more rapidly than lower grades, can occasionally develop from malignant degeneration, and have an overall poor prognosis.19 Ependymomas may also be found outside the nervous system in the soft tissue, ovaries, and mediastinum. Subependymomas (WHO grade I), which may be histologically related to ependymomas, have also been reported as rare IMSCT.51\n', 'Ependymomas tend to be centrally located within the cord and display symmetric expansion with diffuse heterogeneous enhancement (<xref rid="10-1055-s-0035-1549029-i1400020-2" ref-type="fig">Fig. 2</xref>). They tend to occupy the whole width of the cord and generally produce enhanced margins (). They tend to occupy the whole width of the cord and generally produce enhanced margins (<xref rid="10-1055-s-0035-1549029-i1400020-2" ref-type="fig">Fig. 2</xref>). Astrocytomas, in comparison, tend to be eccentrically positioned, may display an exophytic component, and can be nonenhancing or heterogeneously enhancing or even have an enhancing nodule (). Astrocytomas, in comparison, tend to be eccentrically positioned, may display an exophytic component, and can be nonenhancing or heterogeneously enhancing or even have an enhancing nodule (<xref rid="10-1055-s-0035-1549029-i1400020-1" ref-type="fig">Fig. 1</xref>).).76\n77 Radiographically, they do not present with well-defined borders but large satellite cysts may be visualized.78\n79\n80 Polar cysts may appear and have a low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Intradural hemorrhage may be seen in both types of glioma but are more likely in ependymoma, with the imaging characteristics dependent on the age of the hemorrhage and possible secondary development of syrinx.'], '10-1055-s-0035-1549029-i1400020-4': ['Hemangioblastomas are small benign richly vascularized solitary neoplasms that rarely extend beyond one or two segments. Although more often located in the cerebellum, hemangioblastomas are also found in the spinal cord, predominantly located at the posterior or posterolateral region of the spinal canal (<xref rid="10-1055-s-0035-1549029-i1400020-4" ref-type="fig">Fig. 4</xref>). Most hemangioblastomas develop sporadically but, as previously mentioned, they are associated with VHL, especially when presenting in the spinal cord. They constitute between 2 and 8% of all IMSCTs.). Most hemangioblastomas develop sporadically but, as previously mentioned, they are associated with VHL, especially when presenting in the spinal cord. They constitute between 2 and 8% of all IMSCTs.1 Commonly, they are located in the cervical spine but may be found in any portion of the neuroaxis. Cyst formation is evident within 50 to 70% of tumors, and the tumors have an association with syrinx.52\n53\n54 Hemangioblastomas are more commonly found in men.52\n53\n54\n55 Although hemangioblastomas are not age discriminant, most occur during the fourth decade of life. It is possible that individuals with a hemangioblastoma can remain asymptomatic throughout life, with tumor only apparent at autopsy.55\n', 'Hemangioblastomas are richly vascularized tumors that can have significant surrounding edema.81 They are associated with syringomyelia, can be found at any spinal level, and are most commonly sporadic. In patients with VHL, they are associated with additional visceral lesions or neuraxis hemangioblastomas. On MRI, they have mural nodules, which appear isointense on T1-weighted images and hyperintense on T2-weighted images with homogenous contrast enhancement, in contrast to the usual heterogenous contrast pattern of ependymomas and astrocytomas (<xref rid="10-1055-s-0035-1549029-i1400020-4" ref-type="fig">Fig. 4</xref>).).76 Vascular imaging or even spinal angiography may be useful to delineate feeding vessels and illustrate associated dilated pial veins due to vascular shunting and can be helpful for consideration of preoperative embolization in these highly vascular lesions.']} | Intramedullary Spinal Cord Tumors: Part I—Epidemiology, Pathophysiology, and Diagnosis | [
"intradural",
"intramedullary",
"spinal",
"cord",
"tumors",
"epidemiology",
"ependymoma",
"astrocytoma"
] | Global Spine J | 1446274800 | Study Design Computed tomography-based cohort study. Objective Although there are publications concerning the relationship between the vertebral artery and uncinate process, there is no practical guide detailing the dimensions of this region to use during decompression of the intervertebral foramen. The purpose of this study is to determine the anatomic parameters that can be used as a guide for thorough decompression of the intervertebral foramen. Methods Fifty-one patients with three-dimensional computed tomography scans of the cervical spine from 2003 to 2012 were included. On axial views, we measured the distance from the midline to the medial and lateral cortices of the pedicle bilaterally from C3 to C7. On coronal reconstructed views, we measured the minimum height of the uncinate process from the cranial cortex of the pedicle adjacent to the posterior cortex of vertebral body and the maximal height of the uncinate process from the cranial cortex of the pedicle at the midportion of the vertebral body bilaterally from C3 to C7. Results The mean distances from midline to the medial and lateral cortices of the pedicle were 10.1 ± 1.3 mm and 13.9 ± 1.5 mm, respectively. The mean minimum height of the uncinate process from the cranial cortex of the pedicle was 4.6 ± 1.6 mm and the mean maximal height was 6.1 ± 1.7 mm. Conclusions Our results suggest that in most cases, one can thoroughly decompress the intervertebral foramen by removing the uncinate out to 13 mm laterally from the midline and 4 mm above the pedicle without violating the transverse foramen. | [] | other | PMC4577312 | null | 17 | [
"{'Citation': 'Pait T G, Killefer J A, Arnautovic K I. Surgical anatomy of the anterior cervical spine: the disc space, vertebral artery, and associated bony structures. Neurosurgery. 1996;39(4):769–776.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8880772'}}}",
"{'Citation': 'Uğur H C Uz A Attar A Tekdemir I Egemen N Elhan A Anatomical projection of the cervical uncinate process in ventral, ventrolateral, and posterior decompressive surgery J Neurosurg 200093(2, Suppl):248–251.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11012055'}}}",
"{'Citation': 'Yilmazlar S, Kocaeli H, Uz A, Tekdemir I. Clinical importance of ligamentous and osseous structures in the cervical uncovertebral foraminal region. Clin Anat. 2003;16(5):404–410.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12903062'}}}",
"{'Citation': 'Brigham C D, Tsahakis P J. Anterior cervical foraminotomy and fusion. Surgical technique and results. Spine (Phila Pa 1976) 1995;20(7):766–770.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7701387'}}}",
"{'Citation': 'Oh S H, Perin N I, Cooper P R. Quantitative three-dimensional anatomy of the subaxial cervical spine: implication for anterior spinal surgery. Neurosurgery. 1996;38(6):1139–1144.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8727144'}}}",
"{'Citation': 'Lu J, Ebraheim N A, Yang H, Skie M, Yeasting R A. Cervical uncinate process: an anatomic study for anterior decompression of the cervical spine. Surg Radiol Anat. 1998;20(4):249–252.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9787390'}}}",
"{'Citation': 'Russo V M, Graziano F, Peris-Celda M, Russo A, Ulm A J. The V(2) segment of the vertebral artery: anatomical considerations and surgical implications. J Neurosurg Spine. 2011;15(6):610–619.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21905775'}}}",
"{'Citation': 'Uğur H C Attar A Uz A et al.Surgical anatomic evaluation of the cervical pedicle and adjacent neural structures Neurosurgery 20004751162–1168., discussion 1168–1169', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11063110'}}}",
"{'Citation': 'Gupta R, Kapoor K, Sharma A, Kochhar S, Garg R. Morphometry of typical cervical vertebrae on dry bones and CT scan and its implications in transpedicular screw placement surgery. Surg Radiol Anat. 2013;35(3):181–189.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22960775'}}}",
"{'Citation': 'Ebraheim N A, Lu J, Brown J A, Biyani A, Yeasting R A. Vulnerability of vertebral artery in anterolateral decompression for cervical spondylosis. Clin Orthop Relat Res. 1996;(322):146–151.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8542690'}}}",
"{'Citation': 'Güvençer M, Men S, Naderi S, Kiray A, Tetik S. The V2 segment of the vertebral artery in anterior and anterolateral cervical spinal surgery: a cadaver angiographic study. Clin Neurol Neurosurg. 2006;108(5):440–445.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15953674'}}}",
"{'Citation': 'Vaccaro A R, Ring D, Scuderi G, Garfin S R. Vertebral artery location in relation to the vertebral body as determined by two-dimensional computed tomography evaluation. Spine (Phila Pa 1976) 1994;19(23):2637–2641.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7899957'}}}",
"{'Citation': 'Hong J T, Park D K, Lee M J, Kim S W, An H S. Anatomical variations of the vertebral artery segment in the lower cervical spine: analysis by three-dimensional computed tomography angiography. Spine (Phila Pa 1976) 2008;33(22):2422–2426.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18923317'}}}",
"{'Citation': 'Curylo L J, Mason H C, Bohlman H H, Yoo J U. Tortuous course of the vertebral artery and anterior cervical decompression: a cadaveric and clinical case study. Spine (Phila Pa 1976) 2000;25(22):2860–2864.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11074670'}}}",
"{'Citation': 'Tubbs R S, Rompala O J, Verma K. et al.Analysis of the uncinate processes of the cervical spine: an anatomical study. J Neurosurg Spine. 2012;16(4):402–407.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22264177'}}}",
"{'Citation': 'Civelek E, Kiris T, Hepgul K, Canbolat A, Ersoy G, Cansever T. Anterolateral approach to the cervical spine: major anatomical structures and landmarks. Technical note. J Neurosurg Spine. 2007;7(6):669–678.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18074695'}}}",
"{'Citation': 'Ebraheim N A, Lu J, Biyani A, Brown J A, Yeasting R A. Anatomic considerations for uncovertebral involvement in cervical spondylosis. Clin Orthop Relat Res. 1997;(334):200–206.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9005914'}}}"
] | Global Spine J. 2015 Oct 31; 5(5):425-435 | NO-CC CODE |
|
Axial T2 (A) and coronal T2 (B) images of the upper abdomen showing a thrombus involving the right portal vein (red arrows). | amjcaserep-16-627-g001 | 7 | 19a52b73acd230c3abc0d5e58edb3b3e24ab6ed024500a4398b12ae25ef1e796 | amjcaserep-16-627-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
739
] | [{'image_id': 'amjcaserep-16-627-g002', 'image_file_name': 'amjcaserep-16-627-g002.jpg', 'image_path': '../data/media_files/PMC4578645/amjcaserep-16-627-g002.jpg', 'caption': 'Axial (A) and coronal (B) post-contrast T1 fat saturation images showing a filling defect involving the right portal vein and extending to its segmental branches with associated minor perfusion geographical changes.', 'hash': '385779314b4f2cc03c17e665de98bb20bb76ccd3e9f8e8ce5c4c7ad20f0d69f8'}, {'image_id': 'amjcaserep-16-627-g001', 'image_file_name': 'amjcaserep-16-627-g001.jpg', 'image_path': '../data/media_files/PMC4578645/amjcaserep-16-627-g001.jpg', 'caption': 'Axial T2 (A) and coronal T2 (B) images of the upper abdomen showing a thrombus involving the right portal vein (red arrows).', 'hash': '19a52b73acd230c3abc0d5e58edb3b3e24ab6ed024500a4398b12ae25ef1e796'}] | {'amjcaserep-16-627-g001': ['A 31-year-old man presented with right upper-quadrant abdominal pain, fever, and vomiting for 7 days but had no history of jaundice. The laboratory findings revealed impaired liver function profile with high alanine aminotransferase (65 U/l), aspartate aminotransferase (65 U/l), total bilirubin (90 umol/l) and alkaline phosphatase (312 U/l). Anti-thrombin III was slightly raised at 122% (reference range: 80–120%). The coagulation profile was unremarkable, with no deficiency of protein C and S, negative finding for factor V Leiden, and complement component 3 (C3 and 4) was 156 and 51 mg/dl, respectively. Anti-smooth muscle antibody, anti-mitochondrial antibody, anti-nuclear antibody, anti-LKM antibody, and viral hepatitis screens were negative. The blood culture report was also negative. Our case had no history of splenectomy. Abdominal ultrasonography showed features of acute cholecystitis and right portal vein thrombosis. Moreover, the magnetic resonance imaging (MRI) study confirmed the diagnosis of PVT (<xref ref-type="fig" rid="amjcaserep-16-627-g001">Figures 1</xref>, , <xref ref-type="fig" rid="amjcaserep-16-627-g002">2</xref>). The patient was managed conservatively with intravenous antibiotics and anticoagulation. Within few days, the patient started recovering with normalization of the liver function profile and subsequently, he was discharged home on the 8th day post hospitalization.). The patient was managed conservatively with intravenous antibiotics and anticoagulation. Within few days, the patient started recovering with normalization of the liver function profile and subsequently, he was discharged home on the 8th day post hospitalization.']} | Acute Cholecystitis Complicated with Portal Vein Thrombosis: A Case Report and Literature Review | [
"Cholecystitis, Acute",
"Diagnosis",
"Portal Vein"
] | Am J Case Rep | 1442473200 | Tibia fracture induces exaggerated substance P (SP) and calcitonin gene-related peptide (CGRP) signaling and neuropeptide-dependent nociceptive and inflammatory changes in the hind limbs of rats similar to those seen in complex regional pain syndrome. Inflammatory changes in the spinal cord contribute to nociceptive sensitization in a variety of animal pain models. This study tested the hypothesis that fracture-induced exaggerated neuropeptide signaling upregulates spinal inflammatory mediator expression, leading to postfracture hind limb nociceptive sensitization. At 4 weeks after performing tibia fracture and casting in rats, we measured hind limb allodynia, unweighting, warmth, edema, and spinal cord neuropeptide and inflammatory mediator content. The antinociceptive effects of intrathecally injected neuropeptide and inflammatory mediator receptor antagonists were evaluated in fracture rats. Transgenic fracture mice lacking SP or the CGRP RAMP1 receptor were used to determine the effects of neuropeptide signaling on postfracture pain behavior and spinal inflammatory mediator expression. Hind limb allodynia, unweighting, warmth, edema, increased spinal SP and CGRP, and increased spinal inflammatory mediator expression (TNF, IL-1, IL-6, CCL2, and nerve growth factor) were observed at 4 weeks after fracture in rats. Fracture-induced increases in spinal inflammatory mediators were not observed in fracture mice lacking SP or the CGRP receptor, and these mice had attenuated postfracture nociceptive sensitization. Intrathecal injection of selective receptor antagonists for SP, CGRP, TNF, IL-1, IL-6, CCL2, or nerve growth factor each reduced pain behaviors in the fracture rats. Collectively, these data support the hypothesis that facilitated spinal neuropeptide signaling upregulates the expression of spinal inflammatory mediators contributing to nociceptive sensitization in a rodent fracture model of complex regional pain syndrome. | [
"Animals",
"Body Temperature",
"Calcitonin Gene-Related Peptide",
"Disease Models, Animal",
"Hyperalgesia",
"Male",
"Mice",
"Mice, Inbred C57BL",
"Neurokinin-1 Receptor Antagonists",
"Neuropeptides",
"Pain",
"Pain Measurement",
"Peptide Fragments",
"Rats",
"Rats, Sprague-Dawley",
"Signal Transduction",
"Spinal Cord",
"Substance P",
"Tibial Fractures",
"Up-Regulation"
] | other | PMC4578645 | null | 49 | [
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"{'Citation': 'Li WW, Guo TZ, Li XQ, Kingery WS, Clark JD. Fracture induces keratinocyte activation, proliferation, and expression of pro-nociceptive inflammatory mediators. PAIN 2010;151:843–52.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2972360'}, {'@IdType': 'pubmed', '#text': '20934254'}]}}",
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"{'Citation': 'Poree LR, Guo TZ, Kingery WS, Maze M. The analgesic potency of dexmedetomidine is enhanced after nerve injury: a possible role for peripheral alpha2-adrenoceptors. Anesth Analg 1998;87:941–48.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9768799'}}}",
"{'Citation': 'Ren K, Dubner R. Interactions between the immune and nervous systems in pain. Nat Med 2010;16:1267–76.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3077564'}, {'@IdType': 'pubmed', '#text': '20948535'}]}}",
"{'Citation': 'Sabsovich I, Guo TZ, Wei T, Zhao R, Li X, Clark DJ, Geis C, Sommer C, Kingery WS. TNF signaling contributes to the development of nociceptive sensitization in a tibia fracture model of complex regional pain syndrome type I. PAIN 2008;137:507–19.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2529181'}, {'@IdType': 'pubmed', '#text': '18035493'}]}}",
"{'Citation': 'Sabsovich I, Wei T, Guo TZ, Zhao R, Shi X, Li X, Yeomans DC, Klyukinov M, Kingery WS, Clark JD. Effect of anti-NGF antibodies in a rat tibia fracture model of complex regional pain syndrome type I. PAIN 2008;138:47–60.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2538487'}, {'@IdType': 'pubmed', '#text': '18083307'}]}}",
"{'Citation': 'Sandroni P, Benrud-Larson LM, McClelland RL, Low PA. Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study. PAIN 2003;103:199–207.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12749974'}}}",
"{'Citation': 'Schinkel C, Gaertner A, Zaspel J, Zedler S, Faist E, Schuermann M. Inflammatory mediators are altered in the acute phase of posttraumatic complex regional pain syndrome. Clin J Pain 2006;22:235–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16514322'}}}",
"{'Citation': 'Shi X, Wang L, Clark JD, Kingery WS. Keratinocytes express cytokines and nerve growth factor in response to neuropeptide activation of the ERK1/2 and JNK MAPK transcription pathways. Regul Pept 2013;186:92–103.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3799830'}, {'@IdType': 'pubmed', '#text': '23958840'}]}}",
"{'Citation': 'Sun J, Ramnath RD, Zhi L, Tamizhselvi R, Bhatia M. Substance P enhances NF-kappaB transactivation and chemokine response in murine macrophages via ERK1/2 and p38 MAPK signaling pathways. Am J Physiol Cell Physiol 2008;294:C1586–96.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18434625'}}}",
"{'Citation': 'Tran de QH, Duong S, Bertini P, Finlayson RJ. Treatment of complex regional pain syndrome: a review of the evidence. Can J Anaesth 2010;57:149–66.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20054678'}}}",
"{'Citation': 'Tumati S, Largent-Milnes TM, Keresztes AI, Yamamoto T, Vanderah TW, Roeske WR, Hruby VJ, Varga EV. Tachykinin NK(1) receptor antagonist co-administration attenuates opioid withdrawal-mediated spinal microglia and astrocyte activation. Eur J Pharmacol 2012;684:64–70.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3565540'}, {'@IdType': 'pubmed', '#text': '22724132'}]}}",
"{'Citation': 'Watkins LR, Milligan ED, Maier SF. Glial activation: a driving force for pathological pain. Trends Neurosci 2001;24:450–5.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11476884'}}}",
"{'Citation': 'Watkins LR, Milligan ED, Maier SF. Glial proinflammatory cytokines mediate exaggerated pain states: implications for clinical pain. Adv Exp Med Biol 2003;521:1–21.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12617561'}}}",
"{'Citation': 'Weber M, Birklein F, Neundorfer B, Schmelz M. Facilitated neurogenic inflammation in complex regional pain syndrome. PAIN 2001;91:251–7.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11275381'}}}",
"{'Citation': 'Wei T, Guo TZ, Li WW, Hou S, Kingery W, Clark JD. Keratinocyte expression of inflammatory mediators plays a crucial role in substance P-induced acute and chronic pain. J Neuroinflamm 2012;9:181.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3458986'}, {'@IdType': 'pubmed', '#text': '22824437'}]}}",
"{'Citation': 'Wei T, Li WW, Guo TZ, Zhao R, Wang L, Clark DJ, Oaklander AL, Schmelz M, Kingery WS. Post-junctional facilitation of substance P signaling in a tibia fracture rat model of complex regional pain syndrome type I. PAIN 2009;144:278–86.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2706925'}, {'@IdType': 'pubmed', '#text': '19464118'}]}}",
"{'Citation': 'Wei T, Sabsovich I, Guo TZ, Shi X, Zhao R, Li W, Geis C, Sommer C, Kingery WS, Clark DJ. Pentoxifylline attenuates nociceptive sensitization and cytokine expression in a tibia fracture rat model of complex regional pain syndrome. Eur J Pain 2009;13:253–62.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2673487'}, {'@IdType': 'pubmed', '#text': '18554967'}]}}",
"{'Citation': 'Weidner C, Klede M, Rukwied R, Lischetzki G, Neisius U, Skov PS. Acute effects of substance P and calcitonin gene-related peptide in human skin-a microdialysis study. J Invest Dermatol 2000;115:1015–20.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11121135'}}}",
"{'Citation': 'Wesseldijk F, Huygen FJ, Heijmans-Antonissen C, Niehof SP, Zijlstra FJ. Six years follow-up of the levels of TNF-alpha and IL-6 in patients with complex regional pain syndrome type 1. Mediators Inflamm 2008;2008:469439.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2441694'}, {'@IdType': 'pubmed', '#text': '18596918'}]}}"
] | Am J Case Rep. 2015 Sep 17; 16:627-630 | NO-CC CODE |
|
Sagittal (A) and axial (B) T2W MRI images demonstrating anteriorly located hyperintensities extending from T6 level to conus medullaris and bilaterally symmetric circular high signal foci in the anterior horn cells of the spinal cord, known as owl-eyes or snake-eyes or fried-egg sign, respectively | 10072_2022_6483_Fig1_HTML | 7 | 98430ed07dfc496b7d66e9ebefc29d67c15fc7952932b2b26a882cead1695e43 | 10072_2022_6483_Fig1_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
749,
374
] | [{'image_id': '10072_2022_6483_Fig1_HTML', 'image_file_name': '10072_2022_6483_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC9632575/10072_2022_6483_Fig1_HTML.jpg', 'caption': 'Sagittal (A) and axial (B) T2W MRI images demonstrating anteriorly located hyperintensities extending from T6 level to conus medullaris and bilaterally symmetric circular high signal foci in the anterior horn cells of the spinal cord, known as owl-eyes or snake-eyes or fried-egg sign, respectively', 'hash': '98430ed07dfc496b7d66e9ebefc29d67c15fc7952932b2b26a882cead1695e43'}] | {'10072_2022_6483_Fig1_HTML': ['Urgent thoracic spinal cord MRI was performed and showed non-contiguous foci of anteriorly located T2 hyperintensities extending from T6 level to conus medullaris, whereas axial T2 images revealed characteristic “owl eyes sign” (Fig.\xa0<xref rid="10072_2022_6483_Fig1_HTML" ref-type="fig">1</xref>). There was no evidence of compressive myelopathy or vertebral body infarction. Spinal DWI sequences or angiography were not performed.). There was no evidence of compressive myelopathy or vertebral body infarction. Spinal DWI sequences or angiography were not performed.Fig. 1Sagittal (A) and axial (B) T2W MRI images demonstrating anteriorly located hyperintensities extending from T6 level to conus medullaris and bilaterally symmetric circular high signal foci in the anterior horn cells of the spinal cord, known as owl-eyes or snake-eyes or fried-egg sign, respectively']} | Spinal cord ischemia complicating BNT162b2 mRNA COVID-19 vaccination | null | Neurol Sci | 1698994800 | This paper describes a basic study on the measurement of return loss and change in Smith chart using a microstrip patch antenna (MPA) with concentration transition to perform non-invasive blood glucose measurements. To evaluate blood glucose level changes in the human body, the concentration of measurements was changed 10 times to an equivalent of 100 mg/dL in a range of 0-1000 mg/dL to reflect a concentration of 400 mg/dL, which is the fatal level of diabetes. Five types of MPAs were fabricated that formed resonant frequencies in the 1, 2, 3, 4, and 5 GHz bands, and were used in the experiment. Each MPA constituted a sharp narrow band characteristic and induced a large change in return loss. By measuring the return loss and Smith chart to evaluate the concentration change at resonant frequencies, the return loss was observed to change by an average of 0.058 dB for every 100 mg/dL change, and the impedance magnitudes and phase angles analyzed through the Smith chart were observed to have a certain tendency, which confirmed that they were changed. This study shows that for performing non-invasive measurements of blood sugar level, measuring the change in return loss can provide a more stable and reliable measurement compared to the two methods that are simultaneously used to view the samples. | [] | other | PMC9632575 | null | 16 | [
"{'Citation': 'IDF Diabetes Atlas. International Diabetes Federation. Retrieved November 14, 2019, from. https://www.diabetesatlas.org/en/sections/worldwide-toll-of-diabetes.html'}",
"{'Citation': 'New IDF(2019) Figures show continued increase in diabetes across the globe, reiterating the need for urgent action International Diabetes Federation. Retrieved November 14, from https://www.idf.org/news/94:new-idf-figures-show-continued-increase-in-diabetes-across-the-globe,-reiterating-the-need-for-urgent-action.html'}",
"{'Citation': 'Covid-19 and diabetes. International Diabetes Federation. Retrieved March 5, from https://www.idf.org/news/172:covid-19-and-diabetes.html'}",
"{'Citation': 'Moon CW, Kim GH. The research of design development for a hospital blood glucose meter. J Basic Des Art. 2011;14(1):205–215.'}",
"{'Citation': 'Hong SC, Jang SJ, Kang SH. Development of the electric lancing device and the lancet to prevent the secondary contamination by needlestick injury. J Korea Academia-Ind Cooper Soc. 2011;12(12):5464–5468. doi: 10.5762/KAIS.2011.12.12.5464.', 'ArticleIdList': {'ArticleId': {'@IdType': 'doi', '#text': '10.5762/KAIS.2011.12.12.5464'}}}",
"{'Citation': 'Maruo K, Tsurugi M, Chin J, Ota T, Arimoto H, Yamada Y, Tamura M, Ishii M, Ozaki Y. Noninvasive blood glucose assay using a newly developed near-infrared system. IEEE J Sel Top Quantum Electron. 2003;9(2):322–330. doi: 10.1109/JSTQE.2003.811283.', 'ArticleIdList': {'ArticleId': {'@IdType': 'doi', '#text': '10.1109/JSTQE.2003.811283'}}}",
"{'Citation': 'Vashist SK. Non-invasive glucose monitoring technology in diabetes management: a review. Anal Chim Acta. 2012;750:16–27. doi: 10.1016/j.aca.2012.03.043.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/j.aca.2012.03.043'}, {'@IdType': 'pubmed', '#text': '23062426'}]}}",
"{'Citation': 'Hofmann M, Fersch T, Weigel R, Fischer G, Kissinger D (2011) A novel approach to non-invasive blood glucose measurement based on RF transmission. In:\\xa02011 IEEE international symposium on medical measurements and applications, pp 39–42. 10.1109/MeMeA.2011.5966704'}",
"{'Citation': 'Hofmann M, Fischer G, Weigel R, Kissinger D. Microwave-based noninvasive concentration measurements for biomedical applications. IEEE Trans Microwave Theory Tech. 2013;61(5):2195–2204. doi: 10.1109/TMTT.2013.2250516.', 'ArticleIdList': {'ArticleId': {'@IdType': 'doi', '#text': '10.1109/TMTT.2013.2250516'}}}",
"{'Citation': 'Cano-Garcia H, Gouzouasis I, Sotiriou I, Saha S, Palikaras G, Kosmas P, Kallos E (2016) Reflection and transmission measurements using 60 GHz patch antennas in the presence of animal tissue for non-invasive glucose sensing. In:\\xa02016 10th european conference on antennas and propagation (EuCAP), pp 1–3. 10.1109/EuCAP.2016.7481178'}",
"{'Citation': 'Ackerman E, Gatewood LC, Rosevear JW, Molnar GD. Model studies of blood-glucose regulation. Bull Math Biophys. 1965;27(1):21–37. doi: 10.1007/BF02477259.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/BF02477259'}, {'@IdType': 'pubmed', '#text': '5884133'}]}}",
"{'Citation': 'Topsakal E, Karacolak T, Moreland EC (2011) Glucose-dependent dielectric properties of blood plasma. In:\\xa02011 XXXth URSI general assembly and scientific symposium, pp 1–4. IEEE. 10.1109/URSIGASS.2011.6051324'}",
"{'Citation': 'Vrba J, Karch J, Vrba D (2015) Phantoms for development of microwave sensors for noninvasive blood glucose monitoring. Int J Antennas Propag Article ID 570870, 5 pages. 10.1155/2015/570870'}",
"{'Citation': 'Yilmaz T, Foster R, Hao Y. Broadband tissue mimicking phantoms and a patch resonator for evaluating noninvasive monitoring of blood glucose levels. IEEE Trans Antennas Propag. 2014;62(6):3064–3075. doi: 10.1109/TAP.2014.2313139.', 'ArticleIdList': {'ArticleId': {'@IdType': 'doi', '#text': '10.1109/TAP.2014.2313139'}}}",
"{'Citation': 'Saha S, Cano-Garcia H, Sotiriou I, Lipscombe O, Gouzouasis I, Koutsoupidou M, Palikaras G, Mackenzie R, Reeve T, Kosmas P, Kallos E. A glucose sensing system based on transmission measurements at millimetre waves using micro strip patch antennas. Sci Rep. 2017;7(1):1–11. doi: 10.1038/s41598-017-06926-1.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1038/s41598-017-06926-1'}, {'@IdType': 'pmc', '#text': 'PMC5537249'}, {'@IdType': 'pubmed', '#text': '28761121'}]}}",
"{'Citation': 'Smulders PFM, Buysse MG, Huang MD. Dielectric properties of glucose solutions in the 0.5–67 GHz range. Microw Opt Technol Lett. 2013;55(8):1916–1917. doi: 10.1002/mop.27672.', 'ArticleIdList': {'ArticleId': {'@IdType': 'doi', '#text': '10.1002/mop.27672'}}}"
] | Neurol Sci. 2023 Nov 3; 44(2):457-459 | NO-CC CODE |
|
CT scan showing total opacification of left frontal, ethmoid and maxillary sinus | 12070_2021_2574_Fig1_HTML | 7 | 894b85bd10fa16bc1c5fd80eb5ed2058b4fb53c6f6a321364571dc2d7ef2ef64 | 12070_2021_2574_Fig1_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
336
] | [{'image_id': '12070_2021_2574_Fig1_HTML', 'image_file_name': '12070_2021_2574_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC8060684/12070_2021_2574_Fig1_HTML.jpg', 'caption': 'CT scan showing total opacification of left frontal, ethmoid and maxillary sinus', 'hash': '894b85bd10fa16bc1c5fd80eb5ed2058b4fb53c6f6a321364571dc2d7ef2ef64'}, {'image_id': '12070_2021_2574_Fig2_HTML', 'image_file_name': '12070_2021_2574_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC8060684/12070_2021_2574_Fig2_HTML.jpg', 'caption': 'MRI scan peripherally enhancing subperiosteal lesion in the superomedial extraconal aspect of the left orbit', 'hash': 'bccffc3b12263df52687dc922b509a38b81d0959098a716b7fe4e3fd159b75c7'}, {'image_id': '12070_2021_2574_Fig3_HTML', 'image_file_name': '12070_2021_2574_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC8060684/12070_2021_2574_Fig3_HTML.jpg', 'caption': 'The figure shows the barrier draping method with three ports', 'hash': 'e768e7c1e0fce28fc4561e5b7c42ef6a8db9ab8ded09412f3a15694ef102116a'}] | {'12070_2021_2574_Fig1_HTML': ['A 32\xa0year old lady with uncontrolled diabetes since six months presented with left eye complete ptosis and left facial pain since 5\xa0days. On ophthalmic evaluation her visual acuity in left eye was 6/36, pupil was 4\xa0mm dilated and fixed, not reacting to light and extraocular movements were restricted. Right eye was normal. She was referred to Department of Otorhinolaryngology for evaluation. Nasal endoscopy was done and she had deviated nasal septum to the right with spur. Pus was visualized in the left middle meatal region and swab was sent for culture and sensitivity. On radiological evaluation, CT scan nose and Paranasal sinus showed near total opacification of the left ethmoid, maxillary and frontal sinus suggestive of fungal sinusitis. Thickening of the left optic nerve with perineural fat stranding was also noted [Fi<xref rid="12070_2021_2574_Fig1_HTML" ref-type="fig">g.1</xref>]. MRI Brain was also done and showed peripherally enhancing subperiosteal lesion in the superomedial extraconal aspect of the left orbit which was suggestive of subperiosteal abscess with optic neuritis secondary to sinusitis [Fi]. MRI Brain was also done and showed peripherally enhancing subperiosteal lesion in the superomedial extraconal aspect of the left orbit which was suggestive of subperiosteal abscess with optic neuritis secondary to sinusitis [Fi<xref rid="12070_2021_2574_Fig2_HTML" ref-type="fig">g.2</xref>]. She was planned for emergency endoscopic surgery with or without debridement. Cartridge-based nucleic acid amplification test (CBNAAT) for COVID-19 was done on an emergency basis and her report came as Covid positive. In view of impending orbital apex syndrome and the surgery falling in Group A []. She was planned for emergency endoscopic surgery with or without debridement. Cartridge-based nucleic acid amplification test (CBNAAT) for COVID-19 was done on an emergency basis and her report came as Covid positive. In view of impending orbital apex syndrome and the surgery falling in Group A [2] classification of endonasal surgery during covid pandemic, endoscopic sinus surgery was planned with adequate precautions. The surgical steps during surgery remained the same.The following precautions were taken during surgery –The surgical and anesthesia team wore Personal protective equipment (PPE), surgical cap, N-95 mask, hood and double gloves.Pre-operatively betadine (0.5%) drops [3] were instilled in each nostril of patient half an hour before procedure and after induction on the operative table.Surgical tent was created and secured by using barrier draping technique [4]. Three out pouches were created in drape – two for surgeon’s hand, and the third opening was for suction, camera and light carrier [Fi<xref rid="12070_2021_2574_Fig3_HTML" ref-type="fig">g.3</xref>].].Strict donning and doffing measures were followed.Fig. 1CT scan showing total opacification of left frontal, ethmoid and maxillary sinusFig. 2MRI scan peripherally enhancing subperiosteal lesion in the superomedial extraconal aspect of the left orbitFig. 3The figure shows the barrier draping method with three ports']} | Title of the Article: Paranasal Mucormycosis in COVID-19 Patient | [
"COVID-19",
"Mucormycosis",
"Orbital apex syndrome"
] | Indian J Otolaryngol Head Neck Surg | 1666422000 | None | null | other | PMC8060684 | null | null | [
""
] | Indian J Otolaryngol Head Neck Surg. 2022 Oct 22; 74(Suppl 2):3407-3410 | NO-CC CODE |
|
Computed tomographic scan of a rabbit with severe retrobulbar disease. A large mass (arrows) is present in the retrobulbar area, displacing the globe (arrowhead) dorsally and causing severe exophthalmos. | gr5 | 7 | 4678af294cbe7ddf5b4d1fb66f40687850d2c7b31bff25964dea74bd2aa1b269 | gr5.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
377,
426
] | [{'image_id': 'gr7', 'image_file_name': 'gr7.jpg', 'image_path': '../data/media_files/PMC7150065/gr7.jpg', 'caption': 'Osseous metaplasia of the mesectodermal trabecular meshwork in a guinea pig. White opaque material is present in the iridocorneal angle.', 'hash': 'e8b017e1847d0857b456f6cc0a3f786258224dc51cdf614b48c595357351b360'}, {'image_id': 'figure39-1', 'image_file_name': 'figure39-1.jpg', 'image_path': '../data/media_files/PMC7150065/figure39-1.jpg', 'caption': 'Diagram of the rabbit nasolacrimal duct. A, Lateral view with inset. The two sharp bends, the proximal maxillary bend (pb), and the bend at the incisor tooth (ib), are indicated. The inset shows the canaliculus (C) and the lacrimal sac (S). B, Dorsoventral view. 1, Proximal portion of the duct extending from the punctum through the proximal maxillary curve; 2, portion of the duct extending from the proximal maxillary curve to the base of the incisor tooth; 3, portion of the duct extending from the base of the incisor tooth to the end of the lacrimal canal; 4, distal portion of the duct extending from the end of the lacrimal canal to the nasal meatus. C, The nasal meatus of the nasolacrimal duct (arrow). The opening is enlarged for diagrammatic purposes.Rights were not granted to include this figure in electronic media. Please refer to the printed book.', 'hash': '8e5f5a6a797401d29d7f52efa494913ee5c1457e5389dd1c99578eeb9f25f6d6'}, {'image_id': 'gr6', 'image_file_name': 'gr6.jpg', 'image_path': '../data/media_files/PMC7150065/gr6.jpg', 'caption': 'Conjunctivitis and keratitis in a guinea pig. Note the abundant mucopurulent discharge, corneal vascularization, and fibrosis.', 'hash': 'd9d87ef8e8d3aaf43d31f09db0e8b3facdc6bea4a8aed9860db00ab4f78a7877'}, {'image_id': 'gr2', 'image_file_name': 'gr2.jpg', 'image_path': '../data/media_files/PMC7150065/gr2.jpg', 'caption': 'A, Rabbits have a single nasolacrimal punctum (arrow) in the ventral eyelid. B, Irrigation of the nasolacrimal duct in a rabbit with a 24-gauge Teflon intravenous catheter. (A,', 'hash': '0281c8b0a0117a7cc5a9c164f4d61ef28a9b9b91343c8b692dc08d0c0289fadb'}, {'image_id': 'gr5', 'image_file_name': 'gr5.jpg', 'image_path': '../data/media_files/PMC7150065/gr5.jpg', 'caption': 'Computed tomographic scan of a rabbit with severe retrobulbar disease. A large mass (arrows) is present in the retrobulbar area, displacing the globe (arrowhead) dorsally and causing severe exophthalmos.', 'hash': '4678af294cbe7ddf5b4d1fb66f40687850d2c7b31bff25964dea74bd2aa1b269'}, {'image_id': 'gr4', 'image_file_name': 'gr4.jpg', 'image_path': '../data/media_files/PMC7150065/gr4.jpg', 'caption': 'Rabbit infected with Encephalitozoon cuniculi. A white lesion is present in the iris, protruding into the anterior chamber. Lens involvement with cataract formation is present underneath the iridial lesion.', 'hash': '587208c84f6a4ad5d127db0420580d61cdbe13c55e7eb7b90b0672855c51a532'}, {'image_id': 'gr3', 'image_file_name': 'gr3.jpg', 'image_path': '../data/media_files/PMC7150065/gr3.jpg', 'caption': 'Progressive occlusion of the cornea with conjunctival-like tissue is present in this rabbit. The conjunctival-like tissue is not adhered to the cornea. The disease is not painful.', 'hash': 'b692a1e10ac0c994da589c380beb1286190dca83c53d4db74cb2b27c1e516c9c'}] | {'figure39-1': ['The nasolacrimal system of rabbits has a single nasolacrimal punctum. The punctum is located in the ventral eyelid 3 mm from the eyelid margin, near the medial canthus and ventral to the lacrimal caruncle (<xref rid="figure39-1" ref-type="fig">Fig. 39-1</xref>\n).\n).5, 24 The lacrimal sac is immediately rostral to the punctum and caudal to the nasolacrimal duct aperture. The nasolacrimal duct extends from the orbit to the nasal fossa and runs within the part of the maxilla that forms the lateral wall of the maxillary sinus.24 Approximately 5 to 6 mm within the maxilla, the duct curves sharply and decreases in diameter.5 At the level of the palatine bone, the nasolacrimal duct leaves the bony nasolacrimal canal and makes a sharp turn at the nasolacrimal duct flexure, which is located just caudal to the caudal limit of the incisor tooth roots. The nasolacrimal duct narrows at this flexure in normal rabbits. The duct then follows the ventral margin of the nasoturbinates and exits on the ventromedial aspect of the alar fold just caudal to the mucocutaneous junction of the nares.Figure 39-1Diagram of the rabbit nasolacrimal duct. A, Lateral view with inset. The two sharp bends, the proximal maxillary bend (pb), and the bend at the incisor tooth (ib), are indicated. The inset shows the canaliculus (C) and the lacrimal sac (S). B, Dorsoventral view. 1, Proximal portion of the duct extending from the punctum through the proximal maxillary curve; 2, portion of the duct extending from the proximal maxillary curve to the base of the incisor tooth; 3, portion of the duct extending from the base of the incisor tooth to the end of the lacrimal canal; 4, distal portion of the duct extending from the end of the lacrimal canal to the nasal meatus. C, The nasal meatus of the nasolacrimal duct (arrow). The opening is enlarged for diagrammatic purposes.Rights were not granted to include this figure in electronic media. Please refer to the printed book.(From Burling K, Murphy DJ, da Silva Curiel J, et al: Anatomy of the nasolacrimal duct and its clinical implications. Prog Vet Comp Ophthalmol 1991; 1:33-40.)© 2004 2004'], 'gr2': ['Treatment of epiphora in rabbits can be frustrating. Irrigating the nasolacrimal duct is important to restore patency of the nasolacrimal system. After instilling a topical ophthalmic anesthetic, use a 23-gauge lacrimal cannula or a 24-gauge Teflon intravenous catheter to flush the duct (<xref rid="gr2" ref-type="fig">Fig. 39-2</xref>\n). Recurrence of the obstruction is common, and duct irrigation may need to be repeated every 2 to 3 days or weekly until a few consecutive clear irrigations are obtained. If topical antibiotic therapy is used, a broad-spectrum medication such as triple antibiotic solution is recommended. Topical nonsteroidal, anti-inflammatory ophthalmic medications, such as 0.03% flurbiprofen or 1% diclofenac, may help minimize irritation caused by the procedure. In rabbits with chronic or severe infections, concurrent topical ophthalmic and systemic antibiotic therapy may be needed. Suggested combinations include systemic enrofloxacin (Baytril, Bayer Corporation, Shawnee Mission, KS) and topical ciprofloxacin (Ciloxan, Alcon Laboratories, Inc., Fort Worth, TX) or gentamicin. In rabbits with evidence of underlying incisor root elongation, removal of the incisors can be considered in severe cases.\n). Recurrence of the obstruction is common, and duct irrigation may need to be repeated every 2 to 3 days or weekly until a few consecutive clear irrigations are obtained. If topical antibiotic therapy is used, a broad-spectrum medication such as triple antibiotic solution is recommended. Topical nonsteroidal, anti-inflammatory ophthalmic medications, such as 0.03% flurbiprofen or 1% diclofenac, may help minimize irritation caused by the procedure. In rabbits with chronic or severe infections, concurrent topical ophthalmic and systemic antibiotic therapy may be needed. Suggested combinations include systemic enrofloxacin (Baytril, Bayer Corporation, Shawnee Mission, KS) and topical ciprofloxacin (Ciloxan, Alcon Laboratories, Inc., Fort Worth, TX) or gentamicin. In rabbits with evidence of underlying incisor root elongation, removal of the incisors can be considered in severe cases.Figure 39-2A, Rabbits have a single nasolacrimal punctum (arrow) in the ventral eyelid. B, Irrigation of the nasolacrimal duct in a rabbit with a 24-gauge Teflon intravenous catheter. (A,Courtesy Susan Kelleher, DVM).'], 'gr3': ['Progressive occlusion of the cornea with a conjunctival-like membrane is occasionally seen in rabbits.12, 35 Membranous corneal occlusion, or pseudopterygium, is a pain-free condition that may affect one or both eyes (<xref rid="gr3" ref-type="fig">Fig. 39-3</xref>\n). Ophthalmic examination reveals a circular membrane that originates at the limbus (the junction of the cornea and sclera) and gradually advances over the cornea. In severe cases, only a small central opening is present, allowing visibility of an otherwise normal globe. The membrane does not adhere to the cornea. The cause of this condition is unknown, although trauma has been suggested. Progressive membranous occlusion in rabbits has been compared with pterygium in humans. However, in humans the membrane is triangular and adherent to the cornea, whereas in rabbits it is nonadherent and circumferential from the limbus. Treatment with topical antibiotic or antibiotic-steroid medications has no effect. Surgically resecting the membrane and treating with topical antibiotics after surgery usually result in quick recurrence of the membrane. However, resecting the membrane a few millimeters beyond the limbus and treating with a topical antibiotic-steroid combination after surgery may prevent recurrence. Good results have also been obtained with surgical resection and the use of topical cyclosporine. Another described surgical technique is to incise the membrane into four quarters and suture each quadrant of the membrane to the inside of the eyelids.\n). Ophthalmic examination reveals a circular membrane that originates at the limbus (the junction of the cornea and sclera) and gradually advances over the cornea. In severe cases, only a small central opening is present, allowing visibility of an otherwise normal globe. The membrane does not adhere to the cornea. The cause of this condition is unknown, although trauma has been suggested. Progressive membranous occlusion in rabbits has been compared with pterygium in humans. However, in humans the membrane is triangular and adherent to the cornea, whereas in rabbits it is nonadherent and circumferential from the limbus. Treatment with topical antibiotic or antibiotic-steroid medications has no effect. Surgically resecting the membrane and treating with topical antibiotics after surgery usually result in quick recurrence of the membrane. However, resecting the membrane a few millimeters beyond the limbus and treating with a topical antibiotic-steroid combination after surgery may prevent recurrence. Good results have also been obtained with surgical resection and the use of topical cyclosporine. Another described surgical technique is to incise the membrane into four quarters and suture each quadrant of the membrane to the inside of the eyelids.35 With this technique, recurrence may be prevented for at least 1 year.Figure 39-3Progressive occlusion of the cornea with conjunctival-like tissue is present in this rabbit. The conjunctival-like tissue is not adhered to the cornea. The disease is not painful.(Courtesy David Wilkie, DVM, MS.)'], 'gr4': ['\nEncephalitozoon cuniculi may cause granulomatous encephalitis and renal lesions in rabbits. Many rabbits infected with E. cuniculi are asymptomatic, but neurologic signs can include convulsions, tremors, torticollis, paresis, and coma. Encephalitozoon cuniculi infection has also been associated with phacoclastic uveitis. In one report, examination of phacofragmentation fluid from a rabbit revealed the presence of E. cuniculi DNA.38 Most affected rabbits are young (less than 2 years), and dwarf rabbits appear predisposed to disease. Clinically, a white mass is often seen protruding into the anterior chamber (<xref rid="gr4" ref-type="fig">Fig. 39-4</xref>\n). Careful examination of the anterior segment of the eye with slit lamp biomicroscopy may reveal a break in the anterior lens capsule. The break is frequently hidden by inflammatory material and it may appear as if only the iris is involved in the inflammatory process. A focal cataract is often present in the area of the anterior lens capsule break. Signs of a severe pyogranulomatous anterior uveitis are usually present, such as conjunctival hyperemia, a swollen hyperemic iris, miosis, aqueous flare, and low intraocular pressure. The posterior segment of the eye is initially normal; however, if left untreated, severe uveitis and cataract formation can lead to blindness and possible phthisis bulbi or glaucoma. An abscess in the iris caused by \n). Careful examination of the anterior segment of the eye with slit lamp biomicroscopy may reveal a break in the anterior lens capsule. The break is frequently hidden by inflammatory material and it may appear as if only the iris is involved in the inflammatory process. A focal cataract is often present in the area of the anterior lens capsule break. Signs of a severe pyogranulomatous anterior uveitis are usually present, such as conjunctival hyperemia, a swollen hyperemic iris, miosis, aqueous flare, and low intraocular pressure. The posterior segment of the eye is initially normal; however, if left untreated, severe uveitis and cataract formation can lead to blindness and possible phthisis bulbi or glaucoma. An abscess in the iris caused by P. multocida initially may resemble phacoclastic uveitis. Measuring serum antibody titers for E. cuniculi and P. multocida may aid in the differential diagnosis. Treatment of choice is surgical removal of the lens by phacofragmentation. Because of the rabbit\'s ability to regenerate a lens after this procedure, inserting an artificial lens after phacofragmentation is not recommended. Systemic treatment of E. cuniculi with albendazole (30 mg/kg PO q24h for 30 days, then 15 mg/kg PO q24h for an additional 30 days) has been reported.38 More recently, fenbendazole (20 mg/kg q24h for 28 days) has proved effective in both preventing experimental E. cuniculi infection in rabbits and treating naturally infected, seropositive rabbits.39 If the lens is not removed surgically, control of the uveitis with topical steroidal (such as 1% prednisolone acetate) and nonsteroidal anti-inflammatory medications as well as systemic fenbendazole or albendazole is necessary. Enucleation may be indicated if the uveitis cannot be controlled medically and a chronic painful eye is present.46\nFigure 39-4Rabbit infected with Encephalitozoon cuniculi. A white lesion is present in the iris, protruding into the anterior chamber. Lens involvement with cataract formation is present underneath the iridial lesion.'], 'gr5': ['Retrobulbar disease processes are occasionally seen in rabbits. Clinical signs include progressive exophthalmos, protrusion of the third eyelid, and inability to retropulse the globe. Exposure keratitis may be present if the ability of the eyelids to close properly has been affected. Abscesses are a common cause of retrobulbar disease in rabbits, caused by infection with P. multocida\n3 as well as other aerobic and anaerobic bacterial species. Dental disease with tooth root abscessation is often a predisposing factor, and a good dental examination and skull radiographs are indicated in any rabbit with a suspected retrobulbar mass (see Chapter 34). If available, a computed tomography scan is especially helpful in diagnosis (<xref rid="gr5" ref-type="fig">Fig. 39-5</xref>\n). Retrobulbar neoplasia is uncommon in rabbits.\n). Retrobulbar neoplasia is uncommon in rabbits.Figure 39-5Computed tomographic scan of a rabbit with severe retrobulbar disease. A large mass (arrows) is present in the retrobulbar area, displacing the globe (arrowhead) dorsally and causing severe exophthalmos.'], 'gr6': ['Conjunctivitis is common in guinea pigs (<xref rid="gr6" ref-type="fig">Fig. 39-6</xref>\n). One common cause is \n). One common cause is Chlamydophila psittaci,20 which causes a self-limiting disease manifested by mild chemosis, ocular discharge, and follicle formation. Cytologic examination of a specimen from a conjunctival scraping may reveal intracytoplasmic inclusion bodies in epithelial cells. Treatment is generally considered unnecessary. Vitamin C deficiency in guinea pigs causes conjunctivitis with a flaky discharge. Treatment is directed at correcting the dietary deficiency.Figure 39-6Conjunctivitis and keratitis in a guinea pig. Note the abundant mucopurulent discharge, corneal vascularization, and fibrosis.'], 'gr7': ['Osseous metaplasia of the mesectodermal trabecular meshwork occurs in guinea pigs (<xref rid="gr7" ref-type="fig">Fig. 39-7</xref>\n).\n).14 Clinically, an arc of white, opaque material is visible in the anterior chamber, covering the iridocorneal angle. Vessels may be present overlying the osseous choristoma. Hematopoietic active bone marrow is present. This is usually an incidental finding and no specific treatment is necessary.Figure 39-7Osseous metaplasia of the mesectodermal trabecular meshwork in a guinea pig. White opaque material is present in the iridocorneal angle.(From Brown C, Donnelly T: What\'s your diagnosis? Heterotopic bone in the eyes of a guinea pig. Lab Anim 2002; 31:23-25.)© 2004 Lab Anim2004']} | Ophthalmologic Diseases in Small Pet Mammals | null | Ferrets, Rabbits, and Rodents | 1084863600 | None | null | other | PMC7150065 | null | null | [
""
] | Ferrets, Rabbits, and Rodents. 2004 May 18;:421-428 | NO-CC CODE |
|
CT scan (May-2021) showing the extensive spread of the tumour, A Axial section, B Coronal Section, C Sagittal section; 1-Tracheal lumen severely compromised, 2-Left SCA, 3-Left CCA, 4-Left Brachiocephalic vein, 5-Right Brachiocephalic vein, 6-Brachiocephalic artery | 12070_2021_2837_Fig1_HTML | 7 | c3802b0d801279692e87f976fa9a908e67035f44290ae688118eee9157288cfa | 12070_2021_2837_Fig1_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
708,
556
] | [{'image_id': '12070_2021_2837_Fig2_HTML', 'image_file_name': '12070_2021_2837_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC8396137/12070_2021_2837_Fig2_HTML.jpg', 'caption': 'Intra-operative Images—A After dissection of the tumour, 1-Cervical part of the tumour, 2-Mediastinal part of the tumour, 3-Left Innominate vein, B After removal of the tumour, 1-Right Atrium, 2-Ascending aorta, 3-Left Innominate vein, 4-Innominate artery, 5-Right subclavian artery, 6-Right Common carotid artery, 7-Left common carotid artery, C Excised specimen', 'hash': '38a33696bf2d171a36a364d4bd7c5da8479a9f878c123cba561f32cce895907d'}, {'image_id': '12070_2021_2837_Fig1_HTML', 'image_file_name': '12070_2021_2837_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC8396137/12070_2021_2837_Fig1_HTML.jpg', 'caption': 'CT scan (May-2021) showing the extensive spread of the tumour, A Axial section, B Coronal Section, C Sagittal section; 1-Tracheal lumen severely compromised, 2-Left SCA, 3-Left CCA, 4-Left Brachiocephalic vein, 5-Right Brachiocephalic vein, 6-Brachiocephalic artery', 'hash': 'c3802b0d801279692e87f976fa9a908e67035f44290ae688118eee9157288cfa'}] | {'12070_2021_2837_Fig1_HTML': ['A 10\xa0year old girl underwent a right hemithyroidectomy in May, 2020 for a right sided thyroid swelling. The lesion was found to be continuing into the retrosternal and tracheoesophageal groove intra-operatively. Histopathology was suggestive of pleomorphic liposarcoma. Soon after discharge from the hospital, her parents began to notice a swelling in front of the neck which gradually increased in size. After initial evaluation at the same hospital, she was diagnosed to have a recurrence in August, 2020 and was started on chemotherapy (Adriamycin and Ifosfamide). The ongoing pandemic probably further delayed the treatment, so much so that she completed 6 cycles in February, 2021. But, still her symptoms worsened and she was referred to our hospital due to lack of symptomatic improvement and progressive increase in the size of the swelling. The child became more dyspneic and even complained of orthopnea by the time she was referred to our hospital. The child was planned for radiotherapy first, but as the child became more symptomatic after 1 cycle of radiotherapy mostly due to the underlying tissue edema, it was decided to discontinue further radiotherapy and proceed with emergency surgery. She also had a strong family history of malignancy on the maternal side and was subsequently found out to be heterozygous for Li-Fraumeni syndrome. On local examination, there was a 11\u2009×\u20096\xa0cm multilobulated mobile swelling involving the central part of neck and the inferior border was not palpable because of the retrosternal extension. The latest computed tomography(CT) scan (Fig.\xa0<xref rid="12070_2021_2837_Fig1_HTML" ref-type="fig">1</xref>) revealed a large lobulated hypodense lesion involving the neck and mediastinum causing severe narrowing of the trachea (2.2\xa0mm in maximum expiration) without any infiltration. The mass completely encased superior vena cava (SVC), Right brachiocephalic vein (BCV), Innominate artery, left and right common carotid artery (CCA) with normal contrast opacification (Fig.\xa0) revealed a large lobulated hypodense lesion involving the neck and mediastinum causing severe narrowing of the trachea (2.2\xa0mm in maximum expiration) without any infiltration. The mass completely encased superior vena cava (SVC), Right brachiocephalic vein (BCV), Innominate artery, left and right common carotid artery (CCA) with normal contrast opacification (Fig.\xa0<xref rid="12070_2021_2837_Fig2_HTML" ref-type="fig">2</xref>). It partially encased right pulmonary artery (RPA) and was seen compressing the right atrium without infiltration. On indirect laryngoscopy, she had right vocal cord palsy. She subsequently underwent a positron emission tomography (PET) scan, which revealed similar findings and no distant metastasis. The child also underwent transthoracic echocardiography which revealed a large mediastinal mass overlying the right atrium, right ventricle and partially over the main pulmonary artery without any inflow or outflow obstruction. Keeping all this in mind, the patient was intubated while spontaneously ventilating under bronchoscopic guidance. An armoured endotracheal tube of size 4.5\xa0mm was initially passed with ease which was later exchanged to a bigger tube of 5.5\xa0mm. Through an initial collar incision and with rotation of the carotid sheaths laterally, a well encapsulated 11\u2009×\u20094\xa0cm mass was dissected from behind the hypopharynx. As it extended far into the mediastinum, a sternotomy was performed and bilateral pleural cavities were opened which helped in mobilization and precise dissection. We went ahead with the sternotomy from below upwards using a heavy Mayo scissors rather than the oscillating saw which could have cut through the tumour. Anticipating difficulty in intubation owing to severe narrowing of the trachea, a cardiopulmonary bypass (CPB) machine was kept as a standby where we planned to cannulate the femoral vessels and initiate CPB but fortunately we could do it without CPB. The liposarcoma surrounded the aortic arch, and was lying anterior and lateral to the trachea. First, we proceeded with the dissection in the neck followed by dissection over the right atrium (RA) and right ventricle (RV), followed by dissection over the innominate vein and arch vessels. The tumor was dissected from under the brachiocephalic artery and rotated down from the neck. Since, the lesion was too large, lobulated portions of the mass were removed. A final component was dissected off the distal arch of the aorta to complete the resection. A small part of the capsule of the tumour was left behind near the junction of the SVC and BCV since it was densely adherent to it. The child was tracheostomized on table because her right vocal cord was already damages and although we identified and preserved the left recurrent laryngeal nerve, we were sceptical of its damage. Postoperatively the patient was gradually weaned off ventilator support and was discharged to home on POD-8. Histopathology revealed pleomorphic liposarcoma. The child is doing well in the postoperative period.). It partially encased right pulmonary artery (RPA) and was seen compressing the right atrium without infiltration. On indirect laryngoscopy, she had right vocal cord palsy. She subsequently underwent a positron emission tomography (PET) scan, which revealed similar findings and no distant metastasis. The child also underwent transthoracic echocardiography which revealed a large mediastinal mass overlying the right atrium, right ventricle and partially over the main pulmonary artery without any inflow or outflow obstruction. Keeping all this in mind, the patient was intubated while spontaneously ventilating under bronchoscopic guidance. An armoured endotracheal tube of size 4.5\xa0mm was initially passed with ease which was later exchanged to a bigger tube of 5.5\xa0mm. Through an initial collar incision and with rotation of the carotid sheaths laterally, a well encapsulated 11\u2009×\u20094\xa0cm mass was dissected from behind the hypopharynx. As it extended far into the mediastinum, a sternotomy was performed and bilateral pleural cavities were opened which helped in mobilization and precise dissection. We went ahead with the sternotomy from below upwards using a heavy Mayo scissors rather than the oscillating saw which could have cut through the tumour. Anticipating difficulty in intubation owing to severe narrowing of the trachea, a cardiopulmonary bypass (CPB) machine was kept as a standby where we planned to cannulate the femoral vessels and initiate CPB but fortunately we could do it without CPB. The liposarcoma surrounded the aortic arch, and was lying anterior and lateral to the trachea. First, we proceeded with the dissection in the neck followed by dissection over the right atrium (RA) and right ventricle (RV), followed by dissection over the innominate vein and arch vessels. The tumor was dissected from under the brachiocephalic artery and rotated down from the neck. Since, the lesion was too large, lobulated portions of the mass were removed. A final component was dissected off the distal arch of the aorta to complete the resection. A small part of the capsule of the tumour was left behind near the junction of the SVC and BCV since it was densely adherent to it. The child was tracheostomized on table because her right vocal cord was already damages and although we identified and preserved the left recurrent laryngeal nerve, we were sceptical of its damage. Postoperatively the patient was gradually weaned off ventilator support and was discharged to home on POD-8. Histopathology revealed pleomorphic liposarcoma. The child is doing well in the postoperative period.Fig. 1CT scan (May-2021) showing the extensive spread of the tumour, A Axial section, B Coronal Section, C Sagittal section; 1-Tracheal lumen severely compromised, 2-Left SCA, 3-Left CCA, 4-Left Brachiocephalic vein, 5-Right Brachiocephalic vein, 6-Brachiocephalic arteryFig. 2Intra-operative Images—A After dissection of the tumour, 1-Cervical part of the tumour, 2-Mediastinal part of the tumour, 3-Left Innominate vein, B After removal of the tumour, 1-Right Atrium, 2-Ascending aorta, 3-Left Innominate vein, 4-Innominate artery, 5-Right subclavian artery, 6-Right Common carotid artery, 7-Left common carotid artery, C Excised specimen']} | Surgical Challenges in a Case of a Recurrent Giant Pleomorphic Liposarcoma of Neck And Mediastinum in a Child: A Rare Occurrence | [
"Liposarcoma",
"Recurrence",
"Cervical",
"Mediastinum"
] | Indian J Otolaryngol Head Neck Surg | 1672128000 | None | null | other | PMC8396137 | null | null | [
""
] | Indian J Otolaryngol Head Neck Surg. 2022 Dec 27; 74(Suppl 3):6151-6154 | NO-CC CODE |
|
CT scan with demonstration of right-sided hydronephrosis and perinephric stranding (top left), right ureteral stone designated by arrow (top right), left lower pole renal stone designated by arrow (bottom left), and retrograde pyelogram with bilateral duplicated collecting systems (bottom right). | fig-1 | 7 | e910f507aa4c6164f95d9637787aa30c5d679a3c8b83d177cba943b629c6be5d | fig-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
782
] | [{'image_id': 'fig-2', 'image_file_name': 'fig-2.jpg', 'image_path': '../data/media_files/PMC5587902/fig-2.jpg', 'caption': 'Demonstration of large, loculated rim enhancing right retroperitoneal fluid collection (arrow).', 'hash': '1f4f7d76bd8c6dd8246329c54ec3925f733412f018e1ebb8f6b3ae9424abd8b9'}, {'image_id': 'fig-1', 'image_file_name': 'fig-1.jpg', 'image_path': '../data/media_files/PMC5587902/fig-1.jpg', 'caption': 'CT scan with demonstration of right-sided hydronephrosis and perinephric stranding (top left), right ureteral stone designated by arrow (top right), left lower pole renal stone designated by arrow (bottom left), and retrograde pyelogram with bilateral duplicated collecting systems (bottom right).', 'hash': 'e910f507aa4c6164f95d9637787aa30c5d679a3c8b83d177cba943b629c6be5d'}] | {'fig-1': ['The patient was subsequently taken to the operating room for emergent ureteral stent placement. Cystoscopy with retrograde pyelogram was notable for complete bilateral duplicated collecting systems, and Double-J stents were placed in all four moieties for maximal decompression in the setting of obstructive pyelonephritis (<xref ref-type="fig" rid="fig-1">Fig. 1</xref>). Urine cultures were sent from her renal pelvices, which ultimately grew ). Urine cultures were sent from her renal pelvices, which ultimately grew Candida albicans/dubliniensis. Despite ureteral stent placement, she continued to have fevers, hypotension, and leukocytosis to 30\u2009×\u2009109 cells/L 48 hours after decompression. A repeat CT scan was obtained, which demonstrated progression of her previously visualized right retroperitoneal fluid collection into a loculated, rim-enhancing collection that was concerning for abscess (<xref ref-type="fig" rid="fig-2">Fig. 2</xref>). A percutaneous drain was placed into the abscess by interventional radiology with drainage of >300cc of purulent fluid. A gram stain of the fluid demonstrated many polymorphonuclear leukocytes and gram-positive cocci that did not grow in culture. Day 2 cultures from this fluid ultimately revealed growth of ). A percutaneous drain was placed into the abscess by interventional radiology with drainage of >300cc of purulent fluid. A gram stain of the fluid demonstrated many polymorphonuclear leukocytes and gram-positive cocci that did not grow in culture. Day 2 cultures from this fluid ultimately revealed growth of Actinomyces.']} | Retroperitoneal Actinomycosis: A Rare Sequela of an Infected Obstructing Ureteral Stone | [
"ureteral stones",
"infection/inflammation",
"urolithiasis",
"ureteroscopy",
"actinomycosis",
"pyelonephritis",
"retroperitoneum"
] | J Endourol Case Rep | 1498892400 | The potential of surface-enhanced Raman scattering (SERS) spectroscopy in both laboratory and field analyses depends on the reliable formation of so-called SERS hot spots, such as those formed during gold or silver nanoparticle aggregation. Unfortunately such aggregates are not stable in solution because they typically grow until they precipitate. Here we describe the use of low-molecular-weight hydrogels formed through pH-triggered self-assembly that occurs at a rate that well matches the rates of aggregation of Au or Ag colloids, allowing them to be trapped at the SERS-active point in the aggregation process. We show that the colloid-containing gels give SERS signals similar to the parent colloid but are stable over several months. Moreover, lyophilized gels can be stored as dry powders for subsequent use in the analyses of gases and dissolved analytes by contact with either solutions or vapors. The present system shows how the combination of pH-switchable low-molecular-weight gelators and pH-induced colloid aggregation can be combined to make a highly stable, low-cost SERS platform for the detection of volatile organic compounds and the microvolume analysis of solutions. | [] | other | PMC5587902 | null | 22 | [
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] | J Endourol Case Rep. 2017 Jul 1; 3(1):93-96 | NO-CC CODE |
|
CT scan showing lower pole stone of left kidney (shown with arrow). | fig-1 | 7 | 13f7f5e6966cd3baf71fba47ae7bf830bdc462a5561f646501eabf4a8e0ddc80 | fig-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
660,
493
] | [{'image_id': 'fig-1', 'image_file_name': 'fig-1.jpg', 'image_path': '../data/media_files/PMC5587903/fig-1.jpg', 'caption': 'CT scan showing lower pole stone of left kidney (shown with arrow).', 'hash': '13f7f5e6966cd3baf71fba47ae7bf830bdc462a5561f646501eabf4a8e0ddc80'}, {'image_id': 'fig-2', 'image_file_name': 'fig-2.jpg', 'image_path': '../data/media_files/PMC5587903/fig-2.jpg', 'caption': 'CT scan showing stone in ileal ureter (shown with arrow).', 'hash': '1b9581e35a18c83e287af2f929cc82b65e53b3b6161fb039ec665a0327be11c4'}] | {'fig-1': ['The CT scan showed a 12\u2009mm large renal calculus in the left kidney and a 12\u2009mm ureteral calculus in the lower part of the urinary intestine diversion (<xref ref-type="fig" rid="fig-1">Figs. 1</xref> and and <xref ref-type="fig" rid="fig-2">2</xref>). Ultrasonography of the left kidney revealed a hydronephrosis and the lower pole stone. Laboratory parameters were not elevated. We performed a combined intrarenal surgery (CIRS) through mini-PCNL (M-PCNL; 16.5F Amplatz sheath, STORZ) and flexible URS. Stone disintegration was performed with the holmium:YAG laser. After M-PCNL, a 16F nephrostomy was inserted. On the first postoperative day, ultrasonography and X-ray showed the patient was stone free. Therefore, the nephrostomy was removed on the first postoperative day. After catheter removal at the second postoperative day, the patient was discharged from hospital in absence of subjective complaints. Afterward a stone analysis revealed a calcium phosphate stone.). Ultrasonography of the left kidney revealed a hydronephrosis and the lower pole stone. Laboratory parameters were not elevated. We performed a combined intrarenal surgery (CIRS) through mini-PCNL (M-PCNL; 16.5F Amplatz sheath, STORZ) and flexible URS. Stone disintegration was performed with the holmium:YAG laser. After M-PCNL, a 16F nephrostomy was inserted. On the first postoperative day, ultrasonography and X-ray showed the patient was stone free. Therefore, the nephrostomy was removed on the first postoperative day. After catheter removal at the second postoperative day, the patient was discharged from hospital in absence of subjective complaints. Afterward a stone analysis revealed a calcium phosphate stone.']} | Symptomatic Distal Ureteral Stone in an Ileal Ureter: Treatment by Combined Supine Ureteroscopy and Mini Percutaneous Nephrolithotomy | [
"urinary diversion",
"lithiasis",
"endoscopy",
"treatment",
"ureteroscopy"
] | J Endourol Case Rep | 1498892400 | Cys accessibility and quantitative intact mass spectrometry (MS) analyses have been devised to study the topological transitions of Mhp1, the membrane protein for sodium-linked transport of hydantoins from Microbacterium liquefaciens. Mhp1 has been crystallized in three forms (outward-facing open, outward-facing occluded with substrate bound, and inward-facing open). We show that one natural cysteine residue, Cys327, out of three, has an enhanced solvent accessibility in the inward-facing (relative to the outward-facing) form. Reaction of the purified protein, in detergent, with the thiol-reactive N-ethylmalemide (NEM), results in modification of Cys327, suggesting that Mhp1 adopts predominantly inward-facing conformations. Addition of either sodium ions or the substrate 5-benzyl-l-hydantoin (L-BH) does not shift this conformational equilibrium, but systematic co-addition of the two results in an attenuation of labeling, indicating a shift toward outward-facing conformations that can be interpreted using conventional enzyme kinetic analyses. Such measurements can afford the K for each ligand as well as the stoichiometry of ion-substrate-coupled conformational changes. Mutations that perturb the substrate binding site either result in the protein being unable to adopt outward-facing conformations or in a global destabilization of structure. The methodology combines covalent labeling, mass spectrometry, and kinetic analyses in a straightforward workflow applicable to a range of systems, enabling the interrogation of changes in a protein's conformation required for function at varied concentrations of substrates, and the consequences of mutations on these conformational transitions. | [
"Bacterial Proteins",
"Binding Sites",
"Cysteine",
"Ethylmaleimide",
"Hydantoins",
"Kinetics",
"Mass Spectrometry",
"Membrane Transport Proteins",
"Micrococcaceae",
"Molecular Dynamics Simulation",
"Mutagenesis, Site-Directed",
"Protein Binding",
"Sodium",
"Substrate Specificity"
] | other | PMC5587903 | null | 77 | [
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] | J Endourol Case Rep. 2017 Jul 1; 3(1):90-92 | NO-CC CODE |
|
CT scan showing stone in ileal ureter (shown with arrow). | fig-2 | 7 | 1b9581e35a18c83e287af2f929cc82b65e53b3b6161fb039ec665a0327be11c4 | fig-2.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
660,
499
] | [{'image_id': 'fig-1', 'image_file_name': 'fig-1.jpg', 'image_path': '../data/media_files/PMC5587903/fig-1.jpg', 'caption': 'CT scan showing lower pole stone of left kidney (shown with arrow).', 'hash': '13f7f5e6966cd3baf71fba47ae7bf830bdc462a5561f646501eabf4a8e0ddc80'}, {'image_id': 'fig-2', 'image_file_name': 'fig-2.jpg', 'image_path': '../data/media_files/PMC5587903/fig-2.jpg', 'caption': 'CT scan showing stone in ileal ureter (shown with arrow).', 'hash': '1b9581e35a18c83e287af2f929cc82b65e53b3b6161fb039ec665a0327be11c4'}] | {'fig-1': ['The CT scan showed a 12\u2009mm large renal calculus in the left kidney and a 12\u2009mm ureteral calculus in the lower part of the urinary intestine diversion (<xref ref-type="fig" rid="fig-1">Figs. 1</xref> and and <xref ref-type="fig" rid="fig-2">2</xref>). Ultrasonography of the left kidney revealed a hydronephrosis and the lower pole stone. Laboratory parameters were not elevated. We performed a combined intrarenal surgery (CIRS) through mini-PCNL (M-PCNL; 16.5F Amplatz sheath, STORZ) and flexible URS. Stone disintegration was performed with the holmium:YAG laser. After M-PCNL, a 16F nephrostomy was inserted. On the first postoperative day, ultrasonography and X-ray showed the patient was stone free. Therefore, the nephrostomy was removed on the first postoperative day. After catheter removal at the second postoperative day, the patient was discharged from hospital in absence of subjective complaints. Afterward a stone analysis revealed a calcium phosphate stone.). Ultrasonography of the left kidney revealed a hydronephrosis and the lower pole stone. Laboratory parameters were not elevated. We performed a combined intrarenal surgery (CIRS) through mini-PCNL (M-PCNL; 16.5F Amplatz sheath, STORZ) and flexible URS. Stone disintegration was performed with the holmium:YAG laser. After M-PCNL, a 16F nephrostomy was inserted. On the first postoperative day, ultrasonography and X-ray showed the patient was stone free. Therefore, the nephrostomy was removed on the first postoperative day. After catheter removal at the second postoperative day, the patient was discharged from hospital in absence of subjective complaints. Afterward a stone analysis revealed a calcium phosphate stone.']} | Symptomatic Distal Ureteral Stone in an Ileal Ureter: Treatment by Combined Supine Ureteroscopy and Mini Percutaneous Nephrolithotomy | [
"urinary diversion",
"lithiasis",
"endoscopy",
"treatment",
"ureteroscopy"
] | J Endourol Case Rep | 1498892400 | Cys accessibility and quantitative intact mass spectrometry (MS) analyses have been devised to study the topological transitions of Mhp1, the membrane protein for sodium-linked transport of hydantoins from Microbacterium liquefaciens. Mhp1 has been crystallized in three forms (outward-facing open, outward-facing occluded with substrate bound, and inward-facing open). We show that one natural cysteine residue, Cys327, out of three, has an enhanced solvent accessibility in the inward-facing (relative to the outward-facing) form. Reaction of the purified protein, in detergent, with the thiol-reactive N-ethylmalemide (NEM), results in modification of Cys327, suggesting that Mhp1 adopts predominantly inward-facing conformations. Addition of either sodium ions or the substrate 5-benzyl-l-hydantoin (L-BH) does not shift this conformational equilibrium, but systematic co-addition of the two results in an attenuation of labeling, indicating a shift toward outward-facing conformations that can be interpreted using conventional enzyme kinetic analyses. Such measurements can afford the K for each ligand as well as the stoichiometry of ion-substrate-coupled conformational changes. Mutations that perturb the substrate binding site either result in the protein being unable to adopt outward-facing conformations or in a global destabilization of structure. The methodology combines covalent labeling, mass spectrometry, and kinetic analyses in a straightforward workflow applicable to a range of systems, enabling the interrogation of changes in a protein's conformation required for function at varied concentrations of substrates, and the consequences of mutations on these conformational transitions. | [
"Bacterial Proteins",
"Binding Sites",
"Cysteine",
"Ethylmaleimide",
"Hydantoins",
"Kinetics",
"Mass Spectrometry",
"Membrane Transport Proteins",
"Micrococcaceae",
"Molecular Dynamics Simulation",
"Mutagenesis, Site-Directed",
"Protein Binding",
"Sodium",
"Substrate Specificity"
] | other | PMC5587903 | null | 77 | [
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] | J Endourol Case Rep. 2017 Jul 1; 3(1):90-92 | NO-CC CODE |
|
Computed tomography (CT) scan showing patchy areas of consolidation in both lungs. Mediastinal lymph node is mildly prominent. | gr1_lrg | 7 | 54da19c4a2aa376310c4d789181dc67f937f86ba64857837757fd448cfc8f0ad | gr1_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
750
] | [{'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC7522641/gr2_lrg.jpg', 'caption': 'Chest X-ray (CXR) showing bilateral paracardiac ground glass opacity with alveolar opacity in upper zone of left lung and right paracardiac region with mild bilateral pleural effusion.', 'hash': '954a7462cf8b20d2cc785fddc04966197a5de9a1a3b4ab3605d13abd6f5f72fb'}, {'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC7522641/gr1_lrg.jpg', 'caption': 'Computed tomography (CT) scan showing patchy areas of consolidation in both lungs. Mediastinal lymph node is mildly prominent.', 'hash': '54da19c4a2aa376310c4d789181dc67f937f86ba64857837757fd448cfc8f0ad'}] | {'gr1_lrg': ['Computerized tomography (CT) showed patchy areas of consolidation in both lungs. On chest X-rays (CXR), there was mild bilateral pleural effusion with bilateral paracardiac ground glass opacity and alveolar opacity in the upper zone of left lung (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, , <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>\n). A pharyngeal swab sample was collected for COVID-19 real-time reverse transcriptase polymerase chain reaction (RT-PCR) as part of a pretransplantation protocol. Unfortunately, the result of the SARS-COV-2 RT-PCR was positive, which was very surprising because the SARS-COV-2 RT-PCR result at the previous hospital was negative.\n). A pharyngeal swab sample was collected for COVID-19 real-time reverse transcriptase polymerase chain reaction (RT-PCR) as part of a pretransplantation protocol. Unfortunately, the result of the SARS-COV-2 RT-PCR was positive, which was very surprising because the SARS-COV-2 RT-PCR result at the previous hospital was negative.Fig. 1Computed tomography (CT) scan showing patchy areas of consolidation in both lungs. Mediastinal lymph node is mildly prominent.Fig. 2Chest X-ray (CXR) showing bilateral paracardiac ground glass opacity with alveolar opacity in upper zone of left lung and right paracardiac region with mild bilateral pleural effusion.']} | Fulminant hepatic failure: A rare and devastating manifestation of Coronavirus disease 2019 in an 11-year-old boy | [
"SARS-COV-2",
"Novel coronavirus disease 2019",
"Fulminant hepatic failure",
"Transplant"
] | Arch Pediatr | 1606636800 | At the time of writing, FIND has listed four CE-marked SARSCoV-2 antigen tests. We evaluated the recently CE-approved rapid POCT SD-Biosensor for SARS-CoV-2 nucleoprotein detection in nasopharyngeal secretions from 330 patients admitted to the Emergency Room for a suspect of COVID-19 and travelers returning home from high risk countries. Sensitivity, specificity, accuracy, negative and predictive values were consistent with the use of the test to mass-screening for SARS-CoV-2 surveillance. | [
"Antigens, Viral",
"Biosensing Techniques",
"COVID-19",
"COVID-19 Testing",
"Humans",
"Immunologic Tests",
"Mass Screening",
"Nasopharynx",
"Nucleoproteins",
"Real-Time Polymerase Chain Reaction",
"SARS-CoV-2",
"Sensitivity and Specificity",
"Viral Proteins"
] | other | PMC7522641 | null | 11 | [
"{'Citation': 'Corman V.M., Landt O., Kaiser M., Molenkamp R., Meijer A., Chu D.K., et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Eurosurveillance [Internet] 2020;25(3) https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.3.2000045 Jan 23 [cited 2020 Feb 11]. Available from:', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.2807/1560-7917.ES.2020.25.3.2000045'}, {'@IdType': 'pmc', '#text': 'PMC6988269'}, {'@IdType': 'pubmed', '#text': '31992387'}]}}",
"{'Citation': 'Mak G.C., Cheng P.K., Lau S.S., Wong K.K., Lau C., Lam E.T., et al. Evaluation of rapid antigen test for detection of SARS-CoV-2 virus. J. Clin. Virol. 2020;129(August)', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7278630'}, {'@IdType': 'pubmed', '#text': '32585619'}]}}",
"{'Citation': 'Porte L., Legarraga P., Vollrath V., Aguilera X., Munita J.M., Araos R., et al. Evaluation of novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples. Int. J. Infect. Dis. 2020;(June) S1201971220304057.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7263236'}, {'@IdType': 'pubmed', '#text': '32497809'}]}}",
"{'Citation': 'Scohy A., Anantharajah A., Bodéus M., Kabamba-Mukadi B., Verroken A., Rodriguez-Villalobos H. Low performance of rapid antigen detection test as frontline testing for COVID-19 diagnosis. J. Clin. Virol. 2020;129(August)', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7240272'}, {'@IdType': 'pubmed', '#text': '32485618'}]}}",
"{'Citation': 'Lambert-Niclot S., Cuffel A., Le Pape S., Vauloup-Fellous C., Morand-Joubert L., Roque-Afonso A.-M., et al. Evaluation of a rapid diagnostic assay for detection of SARS CoV-2 antigen in nasopharyngeal swab. J. Clin. Microbiol. 2020 May 13; JCM.00977-20, jcm;JCM.00977-20v1.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7383555'}, {'@IdType': 'pubmed', '#text': '32404480'}]}}",
"{'Citation': 'Harcourt J., Tamin A., Lu X., Kamili S., Sakthivel S.K., Murray J., et al. Severe acute respiratory syndrome coronavirus 2 from patient with 2019 novel coronavirus disease, United States. Emerg. Infect. Dis. [Internet] 2020;26(6) http://wwwnc.cdc.gov/eid/article/26/6/20-0516_article.htm Jun [cited 2020 May 10]. Available from:', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7258473'}, {'@IdType': 'pubmed', '#text': '32160149'}]}}",
"{'Citation': 'Mavrikou S., Moschopoulou G., Tsekouras V., Kintzios S. Development of a portable, ultra-rapid and ultra-sensitive cell-based biosensor for the direct detection of the SARS-CoV-2 S1 spike protein antigen. Sensors. 2020;20(May (11)):3121.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7309076'}, {'@IdType': 'pubmed', '#text': '32486477'}]}}",
"{'Citation': 'Mertens P., De Vos N., Martiny D., Jassoy C., Mirazimi A., Cuypers L., et al. Development and potential usefulness of the COVID-19 Ag respi-strip diagnostic assay in a pandemic context. Front. Med. 2020;7(May (225)) doi: 10.3389/fmed.2020.00225.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.3389/fmed.2020.00225'}, {'@IdType': 'pmc', '#text': 'PMC7227790'}, {'@IdType': 'pubmed', '#text': '32574326'}]}}",
"{'Citation': 'Scola B.L. Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards. Eur. J. Clin. Microbiol. Infect. Dis. 2020 doi: 10.1007/s10096-020-03913-9.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s10096-020-03913-9'}, {'@IdType': 'pmc', '#text': 'PMC7185831'}, {'@IdType': 'pubmed', '#text': '32342252'}]}}",
"{'Citation': 'Bullard J., Dust K., Funk D., Strong J.E., Alexander D., Garnett L., et al. Predicting infectious SARS-CoV-2 from diagnostic samples. Clin. Infect. Dis. 2020;(May) doi: 10.1093/cid/ciaa63è118.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1093/cid/ciaa63è118'}, {'@IdType': 'pmc', '#text': 'PMC7314198'}, {'@IdType': 'pubmed', '#text': '32442256'}]}}",
"{'Citation': 'Omi K., Takeda Y., Mori M. SARS-CoV-2 qRT-PCR Ct value distribution in Japan and possible utility of rapid antigen testing kit [Internet] Infect. Diseases (except HIV/AIDS) 2020 doi: 10.1101/2020.06.16.20131243. Jun [cited 2020 Aug 12]. Available from:', 'ArticleIdList': {'ArticleId': {'@IdType': 'doi', '#text': '10.1101/2020.06.16.20131243'}}}"
] | Arch Pediatr. 2020 Nov 29; 27(8):502-505 | NO-CC CODE |
|
Screening positron emission tomography fused with computed tomography demonstrating fluorodeoxyglucose-avid multifocal, rounded, peripheral ground-glass nodules, some demonstrating the reversed halo sign, within the right lower, right middle, and left lower lung lobes concerning for an infectious process | 13566_2020_436_Fig1_HTML | 7 | fe021bf5c07ad9c525ad3a043a055e4b8e259d0e7f4b46d62f776887d8a31193 | 13566_2020_436_Fig1_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
708,
552
] | [{'image_id': '13566_2020_436_Fig1_HTML', 'image_file_name': '13566_2020_436_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7524033/13566_2020_436_Fig1_HTML.jpg', 'caption': 'Screening positron emission tomography fused with computed tomography demonstrating fluorodeoxyglucose-avid multifocal, rounded, peripheral ground-glass nodules, some demonstrating the reversed halo sign, within the right lower, right middle, and left lower lung lobes concerning for an infectious process', 'hash': 'fe021bf5c07ad9c525ad3a043a055e4b8e259d0e7f4b46d62f776887d8a31193'}] | {'13566_2020_436_Fig1_HTML': ['PET-CT for oncologic staging demonstrated fluorodeoxyglucose-avid multifocal lower lung, rounded, peripheral ground-glass nodules within the right lower, right middle, and left lower lobes with several opacities demonstrating the reversed halo sign (Fig. <xref rid="13566_2020_436_Fig1_HTML" ref-type="fig">1</xref>). Given the presence of the reversed halo sign, the differential diagnosis strongly suggested viral infection, although this is not diagnostic for COVID-19 pneumonia and includes other non-specific viral infections as well as organizing pneumonia and eosinophilic pneumonia. In this patient with anal cancer, metastatic disease was also considered, even though ground-glass metastases are unusual for squamous cell carcinoma and these findings were not present on a previous CT obtained 6 weeks prior; moreover, CT correlate did not reveal any distant masses or concern for metastatic disease. The findings can be also present in drug pneumonitis, although no therapy had been initiated in this patient.). Given the presence of the reversed halo sign, the differential diagnosis strongly suggested viral infection, although this is not diagnostic for COVID-19 pneumonia and includes other non-specific viral infections as well as organizing pneumonia and eosinophilic pneumonia. In this patient with anal cancer, metastatic disease was also considered, even though ground-glass metastases are unusual for squamous cell carcinoma and these findings were not present on a previous CT obtained 6 weeks prior; moreover, CT correlate did not reveal any distant masses or concern for metastatic disease. The findings can be also present in drug pneumonitis, although no therapy had been initiated in this patient.Fig. 1Screening positron emission tomography fused with computed tomography demonstrating fluorodeoxyglucose-avid multifocal, rounded, peripheral ground-glass nodules, some demonstrating the reversed halo sign, within the right lower, right middle, and left lower lung lobes concerning for an infectious process']} | Early detection of SARS-CoV-2 from staging PET-CT | [
"COVID-19",
"Coronavirus",
"Anal cancer",
"Cancer staging",
"Chemoradiation"
] | J Radiat Oncol | 1601362800 | [
"Hospitalization",
"Humans",
"Risk Factors",
"United States"
] | other | PMC7524033 | null | 8 | [
"{'Citation': 'The US Burden of Disease Collaborators The state of US health, 1990–2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018;319:1444–1472.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC5933332'}, {'@IdType': 'pubmed', '#text': '29634829'}]}}",
"{'Citation': 'Martinez R, Lloyd-Sherlock P, Soliz P. Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990–2017: a population-based study. Lancet Glob Health. 2020;8:e511–e523.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '32199120'}}}",
"{'Citation': 'Bolnick HJ, Bui AL, Bulchis A. Health-care spending attributable to modifiable risk factors in the USA: an economic attribution analysis. Lancet Public Health. 2020;5:e525–e535.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '33007211'}}}",
"{'Citation': 'Tikkanen R, Abrams M. The Commonwealth Fund; Jan 30, 2020. US health care from a global perspective, 2019: higher spending, worse outcomes?https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019'}",
"{'Citation': 'International Monetary Fund . International Monetary Fund; Washington, DC: 2020. World economic outlook database, October 2019.'}",
"{'Citation': 'Maani N, Galea S. COVID-19 and underinvestment in the health of the US population. Milbank Q. 2020;98:239–249.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7296436'}, {'@IdType': 'pubmed', '#text': '32333451'}]}}",
"{'Citation': 'Maani N, Galea S. COVID-19 and underinvestment in the public health infrastructure of the United States. Milbank Q. 2020;98:250–259.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7296430'}, {'@IdType': 'pubmed', '#text': '32333418'}]}}",
"{'Citation': 'WHO . World Health Organization; Geneva: 1948. Constitution of the World Health Organisation.'}"
] | J Radiat Oncol. 2020 Sep 29; 9(3-4):93-95 | NO-CC CODE |
||
CT angiography of abdominal aorta in axial section for Patient 1. (A) Twenty-four hours after bone marrow trephine biopsy from the left PSIS, demonstrating a 20×4×4 cm hypo-isodense mass (white arrow) consistent with a retroperitoneal hematoma. (B) Two weeks after the initial scan, demonstrating a pool of extraluminal contrast (straight arrow) medial to a branch of left internal iliac artery (curved arrow) and; (C) a 19×8×9 cm retroperitoneal hematoma which has increased in size. | amjcaserep-14-489-g001 | 7 | 743fc3298839121ac6a7dbe3a387e505f7e579bafc9548a2aa4941816d9c2497 | amjcaserep-14-489-g001.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
771,
201
] | [{'image_id': 'amjcaserep-14-489-g001', 'image_file_name': 'amjcaserep-14-489-g001.jpg', 'image_path': '../data/media_files/PMC3843570/amjcaserep-14-489-g001.jpg', 'caption': 'CT angiography of abdominal aorta in axial section for Patient 1. (A) Twenty-four hours after bone marrow trephine biopsy from the left PSIS, demonstrating a 20×4×4 cm hypo-isodense mass (white arrow) consistent with a retroperitoneal hematoma. (B) Two weeks after the initial scan, demonstrating a pool of extraluminal contrast (straight arrow) medial to a branch of left internal iliac artery (curved arrow) and; (C) a 19×8×9 cm retroperitoneal hematoma which has increased in size.', 'hash': '743fc3298839121ac6a7dbe3a387e505f7e579bafc9548a2aa4941816d9c2497'}] | {'amjcaserep-14-489-g001': ['A 19-year-old Malay male who weighed 50 kilograms, with a previous history of acute lymphoblastic leukemia presented to hematology ward with neutropenic sepsis. The hemoglobin was 9.5 g/dL, total white cells were 1.2×109/L, and platelets were 24×109/L. The coagulation profile was later revealed to be abnormal, with PT 13.9s (ratio 1.12) and APTT 180s (ratio >4.5). A BM trephine biopsy was performed to confirm disease relapse. Two hours later, the patient became hypotensive (50/30 mmHg). A CT scan of the abdomen showed a large (20×4×4 cm) retroperitoneal hematoma (<xref ref-type="fig" rid="amjcaserep-14-489-g001">Figure 1A</xref>). At that time, no contrast extravasation was reported. He was stabilized with mechanical ventilation, inotrope agents, and blood products. A modified BMF-90 protocol without the intrathecal component was administrated 2 weeks later. Five days into chemotherapy, he complained of severe left iliac fossa pain radiating to the groin and associated with hypotension (80/50 mmHg). The hemoglobin dropped to 4.2 g/dL and platelets were 11×10). At that time, no contrast extravasation was reported. He was stabilized with mechanical ventilation, inotrope agents, and blood products. A modified BMF-90 protocol without the intrathecal component was administrated 2 weeks later. Five days into chemotherapy, he complained of severe left iliac fossa pain radiating to the groin and associated with hypotension (80/50 mmHg). The hemoglobin dropped to 4.2 g/dL and platelets were 11×109/L. A repeat CT scan of the abdomen revealed a massive (19×8×9 cm) hematoma anterior to the left internal iliac vessels, with contrast extravasation from a branch of the left internal iliac artery (<xref ref-type="fig" rid="amjcaserep-14-489-g001">Figure 1B, 1C</xref>). An attempt at angiographic coiling was unsuccessful, and the hemorrhage was terminated using gel foam embolization. A repeat angiogram 24 hours later revealed no further active bleeding and the patient recovered well.). An attempt at angiographic coiling was unsuccessful, and the hemorrhage was terminated using gel foam embolization. A repeat angiogram 24 hours later revealed no further active bleeding and the patient recovered well.']} | Retroperitoneal hemorrhage associated with bone marrow trephine biopsy | [
"bone marrow trephine biopsy",
"retroperitoneal hemorrhage",
"Retroperitoneal hematoma"
] | Am J Case Rep | 1384934400 | The 50th anniversary of dialysotherapy celebrated by nephrologists around the world in 2012 provided an opportunity for discussion on the role of clinical experience in relation to technological progress in the evolution of dialysis, especially of recently observed inadequate decrease in mortality/morbidity rates of patients on chronic dialysis. My report, based on almost 50 years of career in nephrology, refers the evolution of dialysis, from catharsis to modern dialysotherapy with special attention devoted to nowadays gravely underestimated role of clinical experience and personalized professional care for patients. | [
"History, 20th Century",
"History, 21st Century",
"Inventions",
"Nephrology",
"Renal Dialysis"
] | other | PMC3843570 | null | 57 | [
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] | Am J Case Rep. 2013 Nov 20; 14:489-493 | NO-CC CODE |
|
CT scan image and lung ultrasound patterns of patient n°2 with COVID-19 pneumonia in late stage. | gr2_lrg | 7 | 05f3a186710b3090a50d416b25202ae26150d4b3180ba2ffcb83e6d93d6fb62e | gr2_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
468
] | [{'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC7198146/gr1_lrg.jpg', 'caption': 'CT scan image and lung ultrasound patterns of patient n°1 with COVID-19 pneumonia in early stage.', 'hash': '13c0100bbf760344a538a9d2cc6f9176346ddbe8378475751b43b72b41023f4d'}, {'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC7198146/gr2_lrg.jpg', 'caption': 'CT scan image and lung ultrasound patterns of patient n°2 with COVID-19 pneumonia in late stage.', 'hash': '05f3a186710b3090a50d416b25202ae26150d4b3180ba2ffcb83e6d93d6fb62e'}] | {'gr1_lrg': ['In a 70-year-old woman, at admission, CT scan showed the typical pattern of COVID-19 with peripheral ground-glass opacities that were bilateral and multilobar (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>\nA and B). Ground-glass opacities appear as coalescent B-line areas and are associated with irregularities of pleural line (white arrows, \nA and B). Ground-glass opacities appear as coalescent B-line areas and are associated with irregularities of pleural line (white arrows, <xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>A, 1B and C). This pattern alternates with normal area. Nodular or mass-like ground-glass opacities can also reach the periphery and be depicted as small consolidation in subpleural areas (red arrows, A, 1B and C). This pattern alternates with normal area. Nodular or mass-like ground-glass opacities can also reach the periphery and be depicted as small consolidation in subpleural areas (red arrows, <xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>A, B, D and E) or consolidation (yellow arrows, A, B, D and E) or consolidation (yellow arrows, <xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>A, B and E).A, B and E).Fig. 1CT scan image and lung ultrasound patterns of patient n°1 with COVID-19 pneumonia in early stage.'], 'gr2_lrg': ['A 65-year-old male, after 25 days of mechanical ventilation for acute respiratory distress syndrome, developed on the CT scan fibrosis (<xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>\nA and B) consisting of subpleural fibrosis, honeycombing, traction bronchiectasis with anterior distribution and thickened interlobular septal \nA and B) consisting of subpleural fibrosis, honeycombing, traction bronchiectasis with anterior distribution and thickened interlobular septal [5]. These abnormalities using LUS were reported as irregularities of pleural line associated with coalescent B-lines (red arrows <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>A, C and D) or multifocal subpleural consolidation (red arrows, A, C and D) or multifocal subpleural consolidation (red arrows, <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>C and D). Thickened interlobular septal seen as regularly spaced B-lines (yellow arrows C and D). Thickened interlobular septal seen as regularly spaced B-lines (yellow arrows <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>E) combined with thickened pleural line allows the visualisation of secondary pulmonary lobules (white arrow; E) combined with thickened pleural line allows the visualisation of secondary pulmonary lobules (white arrow; <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>E). Thickened interlobular septal and small subpleural consolidations evidenced the major fissure (red arrows E). Thickened interlobular septal and small subpleural consolidations evidenced the major fissure (red arrows <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>B and 2F).B and 2F).Fig. 2CT scan image and lung ultrasound patterns of patient n°2 with COVID-19 pneumonia in late stage.']} | Ultrasound findings in patients with COVID-19 pneumonia in early and late stages: Two case-reports | null | Anaesth Crit Care Pain Med | 1591254000 | [
"Betacoronavirus",
"COVID-19",
"China",
"Coronavirus Infections",
"Endoscopy",
"Gastroenterology",
"Humans",
"Inflammatory Bowel Diseases",
"Pandemics",
"Pneumonia, Viral",
"SARS-CoV-2"
] | other | PMC7198146 | null | 2 | [
"{'Citation': 'Iaccuci M, Cannatelli R, Labarile N. Endoscopy for inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period. Lancet Gastroenterol Hepatol. 2020 doi: 10.1016/S2468-1253(20)30119-9. published online April 16.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/S2468-1253(20)30119-9'}, {'@IdType': 'pmc', '#text': 'PMC7162648'}, {'@IdType': 'pubmed', '#text': '32305075'}]}}",
"{'Citation': 'WHO Coronavirus disease 2019 (COVID-19) situation reports. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/'}"
] | Anaesth Crit Care Pain Med. 2020 Jun 4; 39(3):391-392 | NO-CC CODE |
||
Lumbar MR images of the patient was evaluated by reason of LBP | OAMJMS-4-665-g001 | 7 | c7be500d562f73636b7c4301343b6caad7a670732482cc428ac124b016b7f62b | OAMJMS-4-665-g001.jpg | multiple | multiple panels: images | [
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] | [{'image_id': 'OAMJMS-4-665-g001', 'image_file_name': 'OAMJMS-4-665-g001.jpg', 'image_path': '../data/media_files/PMC5175518/OAMJMS-4-665-g001.jpg', 'caption': 'Lumbar MR images of the patient was evaluated by reason of LBP', 'hash': 'c7be500d562f73636b7c4301343b6caad7a670732482cc428ac124b016b7f62b'}, {'image_id': 'OAMJMS-4-665-g002', 'image_file_name': 'OAMJMS-4-665-g002.jpg', 'image_path': '../data/media_files/PMC5175518/OAMJMS-4-665-g002.jpg', 'caption': 'Lumbar MR images of patient was evaluated due to RP', 'hash': '75dde8aaf65d34d2dfda18c79b0a9358c2a55e1136b94f76197bd4a0d5f17332'}] | {} | The Association between Urinary Incontinence and Low Back Pain and Radiculopathy in Women | [
"Urinary incontinence",
"low back pain",
"radiculopathy",
"urge incontinence",
"stress incontinence"
] | Open Access Maced J Med Sci | 1481788800 | [{'@Label': 'AIM', '@NlmCategory': 'OBJECTIVE', '#text': 'To test the solubility of dual cure resin modified resin cement in a food simulating solution and the shear bond strength compared to conventional Glass ionomer cement.'}, {'@Label': 'MATERIALS AND METHOD', '@NlmCategory': 'METHODS', '#text': 'The materials tested were self-adhesive dual cure resin modified cement and Glass Ionomer (GIC). Twenty Teflon moulds were divided into two groups of tens. The first group was injected and packed with the modified resin cement, the second group was packed with GIC. To test the solubility, each mould was weighed before and after being placed in an analytical reagent for 30 days. The solubility was measured as the difference between the initial and final drying mass. To measure the Shear bond strength, 20 freshly extracted wisdom teeth were equally divided into two groups and embedded in self-cure acrylic resin. Four mm sections of stainless steel bands were cemented to the exposed buccal surfaces of teeth under a constant load of 500 g. Shear bond strength was measured using a computer controlled materials testing machine and the load required to deband the samples was recorded in Newtons.'}, {'@Label': 'RESULTS', '@NlmCategory': 'RESULTS', '#text': 'GIC showed significantly higher mean weight loss and an insignificant lower Shear bond strength, compared to dual cure resin Cement.'}, {'@Label': 'CONCLUSION', '@NlmCategory': 'CONCLUSIONS', '#text': 'It was found that dual cure resin modified cement was less soluble than glass ionomer cement and of comparable bond strength rendering it more useful clinically for orthodontic band cementation.'}] | [] | other | PMC5175518 | null | 24 | [
"{'Citation': 'Ramazanzadeh B A, Merati M, Shafaee H, Dogon L, Sohrabi K. In vitro evaluation of an experimental method for bonding of orthodontic brackets with self-adhesive resin cements. European J Gen Dent. 2013;2(3):264–269. http://dx.doi.org/10.4103/2278-9626.116018 . PMid: 24163808. PMCid: PMC3806483.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3806483'}, {'@IdType': 'pubmed', '#text': '24163808'}]}}",
"{'Citation': 'Hattar S, Hatamleh M M, Sawair F, Al-Rabab’ahl M. Bond strength of self-adhesive resin cements to tooth structure. The Saudi Dental Journal. 2015. in press. http://dx.doi.org/10.1016/j.sdentj.2014.11.006 . PMid: 26082572. PMCid: PMC4459118.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4459118'}, {'@IdType': 'pubmed', '#text': '26082572'}]}}",
"{'Citation': 'Türker S A, Uzunoğlu E, Yılmaz Z. Effects of dentin moisture on the push-out bond strength of a fiber post luted with different self-adhesive resin cements. Restorative dentistry and endodontic. 2013;38(4):234–240.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3843035'}, {'@IdType': 'pubmed', '#text': '24303359'}]}}",
"{'Citation': 'Nakamura T, Wakabayashi K, Kinuta S, Nishida H, Miyamae M, Yatani H. Mechanical properties of new self-adhesive resin-based cement. Journal of Prosthodontic Research. 2010;54:59–64. http://dx.doi.org/10.1016/j.jpor.2009.09.004 . PMid: 19879828.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19879828'}}}",
"{'Citation': 'Millet DT, Kamahli K, McColl J. Comparative laboratory investigation of dual-cured vs. conventional glass ionomer cements for band cementation. Angle Orthod. 1998;68(4):345–350.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9709835'}}}",
"{'Citation': 'Ghanim A. Water sorption and solubility of different commercially available dental cements. (An in vitro study) Babylon medical journal. 2010;7:4.'}",
"{'Citation': 'Manish A, Timothy FF, Douglas R. A Comparison of Shear-Peel Band Strengths of 5 Orthodontic Cements. The Angle Orthodontist. 2000;70(4):308–316.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10961781'}}}",
"{'Citation': 'Yap AUJ, Tan DTT, Goh BKC, Kuah HG, Goh M. Effect of food simulating liquids on the flexure strength of composite and polyacid-modified composite restoratives. J Oper Dent. 2000;25:202–208.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11203817'}}}",
"{'Citation': 'Abdelrahman AM, Amin AM, Sharawy AM. Effect of food simulating liquids on fracture toughness of nano-hybrid composite with different resin matrix formulations. Cairo: Faculty of Oral and Dental Medicine, Cairo University; 2012. Dissertation.'}",
"{'Citation': 'Malacarne J, Carvalho RM, Mario F, Svizero N, Pashley DH, Tay FR, Yiu CK, de Oliveira Carrilho MR. Water sorption/solubility of dental adhesive resins. Dental Materials. 2006;22(10):973–80. http://dx.doi.org/10.1016/j.dental.2005.11.020 . PMid: 16405987.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16405987'}}}",
"{'Citation': 'Vicente A, Bravo LA, Romero M, Ortiz AJ, Canteras M. A Comparison of the Shear Bond Strength of a Resin Cement and Two Orthodontic Resin Adhesive Systems. Angle Orthod. 2004;75:109–113.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15747825'}}}",
"{'Citation': 'De Munck J, Vargas M, Van Landuyt K, Hikita K, Lambrechts P, Van Meerbeek B. Bonding of an auto-adhesive material to enamel and dentin. Dent Mater. 2004;20:963–71. http://dx.doi.org/10.1016/j.dental.2004.03.002 . PMid: 15501325.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15501325'}}}",
"{'Citation': 'Hikita K, Van Meerbeek B, De Munck J, Ikeda T, Van Landuyt K, Maida T, Lambrechts P, Peumans M. Bonding effectiveness of adhesive luting agents to enamel and dentin. Dent Mater. 2007;23:71–80. http://dx.doi.org/10.1016/j.dental.2005.12.002 . PMid: 16426673.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16426673'}}}",
"{'Citation': 'Keyf F, Tuna S H, Sen M, Safrany A. Water Sorption and Solubility of Different Luting and Restorative Dental Cements. Turk J Med Sci. 2007;37(1):47–55.e.'}",
"{'Citation': 'Al-Shekhli A, Abdul Wahab R. Solubility of four dental luting cements. J Int Dent Med Res. 2010;3(3):104–107.'}",
"{'Citation': 'Cattani-Lorente MA, Dupuis V, Payan J, Moya F, Meyer JM. Effect of water on the physical properties of resin-modified glass ionomer cements. Dent Mater. 1999;15:71–79. http://dx.doi.org/10.1016/S0109-5641(99)00016-0 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10483398'}}}",
"{'Citation': 'Toledanoa M, Osorioa R, Osorioa E, Fuentessa V, Pratib C, Garcıa-Godoyc F. Sorption and solubility of resin based restorative dental materials. Journal of Dentistry. 2003;31:43–50. http://dx.doi.org/10.1016/S0300-5712(02)00083-0 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12615019'}}}",
"{'Citation': 'Wison AD. Specification test for the solubility and disintegration of dental cements: a critical evaluation of its meaning. J Dent Res. 1976;55(5):721–9. http://dx.doi.org/10.1177/00220345760550050401 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1067288'}}}",
"{'Citation': 'Macorra JC, Praides G. Conventional and adhesive luting cements. Clin Oral Invest. 2002;6:198–204. http://dx.doi.org/10.1007/s00784-002-0184-1 . PMid: 12483233.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12483233'}}}",
"{'Citation': 'Al-Wahab ZN. An evaluation of the effect of different solutions on the microhardness of aesthetic restoration. MDJ. 2011;8:2.'}",
"{'Citation': 'Chieffi N, Chersoni S, Papacchini F, Vano M, Goracci C, Davidson C L, Tay F R, Ferrari M. The effect of application sustained seating pressure on adhesive luting procedure. Dent Mater. 2007;23:159–164. http://dx.doi.org/10.1016/j.dental.2006.01.006 . PMid: 16494935.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16494935'}}}",
"{'Citation': 'Duarte S, Jr, Botta AC, Meire M, Sadan A. Microtensile bond strengths and scanning electron microscopic evaluation of self-adhesive and self-etch resin cements to intact and etched enamel. J Prosthet Dent. 2008;100:203–210. http://dx.doi.org/10.1016/S0022-3913(08)60179-1 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18762032'}}}",
"{'Citation': 'El-Guindy J, Selim M, El-Agroudi M. Alternative pretreatment modalities with a self-adhesive system to promote dentin/alloy shear bond strength. J Prosthodont. 2010;19:205–211. http://dx.doi.org/10.1111/j.1532-849X.2009.00541.x . PMid: 20040029.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20040029'}}}",
"{'Citation': 'Al-Saleh M, El-Mowafy O. Bond strength of orthodontic brackets with new self-adhesive resin cements. Am J Orthod Dentofacial Orthop. 2010;137:528–33. http://dx.doi.org/10.1016/j.ajodo.2008.04.027 . PMid: 20362914.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20362914'}}}"
] | Open Access Maced J Med Sci. 2016 Dec 15; 4(4):665-669 | NO-CC CODE |
|
Lumbar MR images of patient was evaluated due to RP | OAMJMS-4-665-g002 | 7 | 75dde8aaf65d34d2dfda18c79b0a9358c2a55e1136b94f76197bd4a0d5f17332 | OAMJMS-4-665-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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521,
272
] | [{'image_id': 'OAMJMS-4-665-g001', 'image_file_name': 'OAMJMS-4-665-g001.jpg', 'image_path': '../data/media_files/PMC5175518/OAMJMS-4-665-g001.jpg', 'caption': 'Lumbar MR images of the patient was evaluated by reason of LBP', 'hash': 'c7be500d562f73636b7c4301343b6caad7a670732482cc428ac124b016b7f62b'}, {'image_id': 'OAMJMS-4-665-g002', 'image_file_name': 'OAMJMS-4-665-g002.jpg', 'image_path': '../data/media_files/PMC5175518/OAMJMS-4-665-g002.jpg', 'caption': 'Lumbar MR images of patient was evaluated due to RP', 'hash': '75dde8aaf65d34d2dfda18c79b0a9358c2a55e1136b94f76197bd4a0d5f17332'}] | {} | The Association between Urinary Incontinence and Low Back Pain and Radiculopathy in Women | [
"Urinary incontinence",
"low back pain",
"radiculopathy",
"urge incontinence",
"stress incontinence"
] | Open Access Maced J Med Sci | 1481788800 | [{'@Label': 'AIM', '@NlmCategory': 'OBJECTIVE', '#text': 'To test the solubility of dual cure resin modified resin cement in a food simulating solution and the shear bond strength compared to conventional Glass ionomer cement.'}, {'@Label': 'MATERIALS AND METHOD', '@NlmCategory': 'METHODS', '#text': 'The materials tested were self-adhesive dual cure resin modified cement and Glass Ionomer (GIC). Twenty Teflon moulds were divided into two groups of tens. The first group was injected and packed with the modified resin cement, the second group was packed with GIC. To test the solubility, each mould was weighed before and after being placed in an analytical reagent for 30 days. The solubility was measured as the difference between the initial and final drying mass. To measure the Shear bond strength, 20 freshly extracted wisdom teeth were equally divided into two groups and embedded in self-cure acrylic resin. Four mm sections of stainless steel bands were cemented to the exposed buccal surfaces of teeth under a constant load of 500 g. Shear bond strength was measured using a computer controlled materials testing machine and the load required to deband the samples was recorded in Newtons.'}, {'@Label': 'RESULTS', '@NlmCategory': 'RESULTS', '#text': 'GIC showed significantly higher mean weight loss and an insignificant lower Shear bond strength, compared to dual cure resin Cement.'}, {'@Label': 'CONCLUSION', '@NlmCategory': 'CONCLUSIONS', '#text': 'It was found that dual cure resin modified cement was less soluble than glass ionomer cement and of comparable bond strength rendering it more useful clinically for orthodontic band cementation.'}] | [] | other | PMC5175518 | null | 24 | [
"{'Citation': 'Ramazanzadeh B A, Merati M, Shafaee H, Dogon L, Sohrabi K. In vitro evaluation of an experimental method for bonding of orthodontic brackets with self-adhesive resin cements. European J Gen Dent. 2013;2(3):264–269. http://dx.doi.org/10.4103/2278-9626.116018 . PMid: 24163808. PMCid: PMC3806483.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3806483'}, {'@IdType': 'pubmed', '#text': '24163808'}]}}",
"{'Citation': 'Hattar S, Hatamleh M M, Sawair F, Al-Rabab’ahl M. Bond strength of self-adhesive resin cements to tooth structure. The Saudi Dental Journal. 2015. in press. http://dx.doi.org/10.1016/j.sdentj.2014.11.006 . PMid: 26082572. PMCid: PMC4459118.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4459118'}, {'@IdType': 'pubmed', '#text': '26082572'}]}}",
"{'Citation': 'Türker S A, Uzunoğlu E, Yılmaz Z. Effects of dentin moisture on the push-out bond strength of a fiber post luted with different self-adhesive resin cements. Restorative dentistry and endodontic. 2013;38(4):234–240.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3843035'}, {'@IdType': 'pubmed', '#text': '24303359'}]}}",
"{'Citation': 'Nakamura T, Wakabayashi K, Kinuta S, Nishida H, Miyamae M, Yatani H. Mechanical properties of new self-adhesive resin-based cement. Journal of Prosthodontic Research. 2010;54:59–64. http://dx.doi.org/10.1016/j.jpor.2009.09.004 . PMid: 19879828.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19879828'}}}",
"{'Citation': 'Millet DT, Kamahli K, McColl J. Comparative laboratory investigation of dual-cured vs. conventional glass ionomer cements for band cementation. Angle Orthod. 1998;68(4):345–350.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9709835'}}}",
"{'Citation': 'Ghanim A. Water sorption and solubility of different commercially available dental cements. (An in vitro study) Babylon medical journal. 2010;7:4.'}",
"{'Citation': 'Manish A, Timothy FF, Douglas R. A Comparison of Shear-Peel Band Strengths of 5 Orthodontic Cements. The Angle Orthodontist. 2000;70(4):308–316.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10961781'}}}",
"{'Citation': 'Yap AUJ, Tan DTT, Goh BKC, Kuah HG, Goh M. Effect of food simulating liquids on the flexure strength of composite and polyacid-modified composite restoratives. J Oper Dent. 2000;25:202–208.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11203817'}}}",
"{'Citation': 'Abdelrahman AM, Amin AM, Sharawy AM. Effect of food simulating liquids on fracture toughness of nano-hybrid composite with different resin matrix formulations. Cairo: Faculty of Oral and Dental Medicine, Cairo University; 2012. Dissertation.'}",
"{'Citation': 'Malacarne J, Carvalho RM, Mario F, Svizero N, Pashley DH, Tay FR, Yiu CK, de Oliveira Carrilho MR. Water sorption/solubility of dental adhesive resins. Dental Materials. 2006;22(10):973–80. http://dx.doi.org/10.1016/j.dental.2005.11.020 . PMid: 16405987.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16405987'}}}",
"{'Citation': 'Vicente A, Bravo LA, Romero M, Ortiz AJ, Canteras M. A Comparison of the Shear Bond Strength of a Resin Cement and Two Orthodontic Resin Adhesive Systems. Angle Orthod. 2004;75:109–113.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15747825'}}}",
"{'Citation': 'De Munck J, Vargas M, Van Landuyt K, Hikita K, Lambrechts P, Van Meerbeek B. Bonding of an auto-adhesive material to enamel and dentin. Dent Mater. 2004;20:963–71. http://dx.doi.org/10.1016/j.dental.2004.03.002 . PMid: 15501325.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15501325'}}}",
"{'Citation': 'Hikita K, Van Meerbeek B, De Munck J, Ikeda T, Van Landuyt K, Maida T, Lambrechts P, Peumans M. Bonding effectiveness of adhesive luting agents to enamel and dentin. Dent Mater. 2007;23:71–80. http://dx.doi.org/10.1016/j.dental.2005.12.002 . PMid: 16426673.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16426673'}}}",
"{'Citation': 'Keyf F, Tuna S H, Sen M, Safrany A. Water Sorption and Solubility of Different Luting and Restorative Dental Cements. Turk J Med Sci. 2007;37(1):47–55.e.'}",
"{'Citation': 'Al-Shekhli A, Abdul Wahab R. Solubility of four dental luting cements. J Int Dent Med Res. 2010;3(3):104–107.'}",
"{'Citation': 'Cattani-Lorente MA, Dupuis V, Payan J, Moya F, Meyer JM. Effect of water on the physical properties of resin-modified glass ionomer cements. Dent Mater. 1999;15:71–79. http://dx.doi.org/10.1016/S0109-5641(99)00016-0 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10483398'}}}",
"{'Citation': 'Toledanoa M, Osorioa R, Osorioa E, Fuentessa V, Pratib C, Garcıa-Godoyc F. Sorption and solubility of resin based restorative dental materials. Journal of Dentistry. 2003;31:43–50. http://dx.doi.org/10.1016/S0300-5712(02)00083-0 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12615019'}}}",
"{'Citation': 'Wison AD. Specification test for the solubility and disintegration of dental cements: a critical evaluation of its meaning. J Dent Res. 1976;55(5):721–9. http://dx.doi.org/10.1177/00220345760550050401 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1067288'}}}",
"{'Citation': 'Macorra JC, Praides G. Conventional and adhesive luting cements. Clin Oral Invest. 2002;6:198–204. http://dx.doi.org/10.1007/s00784-002-0184-1 . PMid: 12483233.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12483233'}}}",
"{'Citation': 'Al-Wahab ZN. An evaluation of the effect of different solutions on the microhardness of aesthetic restoration. MDJ. 2011;8:2.'}",
"{'Citation': 'Chieffi N, Chersoni S, Papacchini F, Vano M, Goracci C, Davidson C L, Tay F R, Ferrari M. The effect of application sustained seating pressure on adhesive luting procedure. Dent Mater. 2007;23:159–164. http://dx.doi.org/10.1016/j.dental.2006.01.006 . PMid: 16494935.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16494935'}}}",
"{'Citation': 'Duarte S, Jr, Botta AC, Meire M, Sadan A. Microtensile bond strengths and scanning electron microscopic evaluation of self-adhesive and self-etch resin cements to intact and etched enamel. J Prosthet Dent. 2008;100:203–210. http://dx.doi.org/10.1016/S0022-3913(08)60179-1 .', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18762032'}}}",
"{'Citation': 'El-Guindy J, Selim M, El-Agroudi M. Alternative pretreatment modalities with a self-adhesive system to promote dentin/alloy shear bond strength. J Prosthodont. 2010;19:205–211. http://dx.doi.org/10.1111/j.1532-849X.2009.00541.x . PMid: 20040029.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20040029'}}}",
"{'Citation': 'Al-Saleh M, El-Mowafy O. Bond strength of orthodontic brackets with new self-adhesive resin cements. Am J Orthod Dentofacial Orthop. 2010;137:528–33. http://dx.doi.org/10.1016/j.ajodo.2008.04.027 . PMid: 20362914.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20362914'}}}"
] | Open Access Maced J Med Sci. 2016 Dec 15; 4(4):665-669 | NO-CC CODE |
|
Distances measured in a cross-sectional CBCT image). a – from the inferior border of PSAA canal to the middle of maxillary sinus floor; b – from PSAA canal to the middle of interdental alveolar crest; c – from the floor of maxillary sinus to the center of alveolar crest; d – from PSAA notch to the medial wall of the sinus. | poljradiol-81-606-g002 | 7 | 224a87cc411a4b4905b23b84f494d36effc5f63e325195794d3ffd49263e26a0 | poljradiol-81-606-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
693
] | [{'image_id': 'poljradiol-81-606-g002', 'image_file_name': 'poljradiol-81-606-g002.jpg', 'image_path': '../data/media_files/PMC5175788/poljradiol-81-606-g002.jpg', 'caption': 'Distances measured in a cross-sectional CBCT image). a – from the inferior border of PSAA canal to the middle of maxillary sinus floor; b – from PSAA canal to the middle of interdental alveolar crest; c – from the floor of maxillary sinus to the center of alveolar crest; d – from PSAA notch to the medial wall of the sinus.', 'hash': '224a87cc411a4b4905b23b84f494d36effc5f63e325195794d3ffd49263e26a0'}, {'image_id': 'poljradiol-81-606-g001', 'image_file_name': 'poljradiol-81-606-g001.jpg', 'image_path': '../data/media_files/PMC5175788/poljradiol-81-606-g001.jpg', 'caption': 'Location of the posterior superior alveolar artery canal – intraosseous.', 'hash': 'ba9373849086ea2c849bb6a5a8e02565edc25f5dda142a4a6e99d1b6390c6b15'}] | {'poljradiol-81-606-g001': ['PSAA is a crucial structure located on the lateral wall of maxillary sinus. (<xref ref-type="fig" rid="poljradiol-81-606-g001">Figure 1</xref>) Enlargement of maxillary sinus with age and resorption of alveolar crest, or surgical procedures performed in this area are associated with increased risk of damage [TN] [) Enlargement of maxillary sinus with age and resorption of alveolar crest, or surgical procedures performed in this area are associated with increased risk of damage [TN] [7]. Cone beam computed tomography (CBCT) technology provides numerous advantages, such as reduced costs, decreased radiation dose and availability of 3D maxillofacial imaging, compared to conventional computed tomography (CT) [2].', 'In previous studies authors used OPG, PNS and CT scans to visualize the PSAA [8]. It is very difficult to visualize oral and maxillofacial structures in two dimensions due to their anatomy and superimpositions [9]. CT examination provides finer details at the expense of high radiation dose and higher cost per scan. The aim of the study was to determine the visibility and course of the posterior superior alveolar artery (PSAA) using cone beam computed tomography (CBCT) imaging. (<xref ref-type="fig" rid="poljradiol-81-606-g001">Figure 1</xref>))'], 'poljradiol-81-606-g002': ['The distances were measured in the 1st molar and 2nd molar areas – 1) from PSAA inferior margin to the middle of maxillary sinus floor (a), 2) from PSAA inferior margin to the middle of the interdental alveolar crest (b), 3) from the floor of maxillary sinus to the center of alveolar crest (c), 4) from PSAA notch to the medial wall of the sinus (d) (<xref ref-type="fig" rid="poljradiol-81-606-g002">Figure 2</xref>))']} | Evaluation of the Posterior Superior Alveolar Artery Using Cone Beam Computed Tomography | [
"Cone-Beam Computed Tomography",
"Dental Implants",
"Maxillary Sinus"
] | Pol J Radiol | 1482134400 | Case of a patient is presented here 20 years after spiral direct anastomosis of the great arteries in an arterial switch operation. Three-dimensional model of the heart combined with four-dimensional flow magnetic resonance imaging presents a novel comprehensive way to assess surgical results. | [] | other | PMC5175788 | null | 5 | [
"{'Citation': 'Jatene A D, Fontes V F, Paulista P P. et al.Successful anatomic correction of transposition of the great vessels. A preliminary report. Arq Bras Cardiol. 1975;28(4):461–464.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1200893'}}}",
"{'Citation': 'Lecompte Y, Zannini L, Hazan E. et al.Anatomic correction of transposition of the great arteries. J Thorac Cardiovasc Surg. 1981;82(4):629–631.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '7278356'}}}",
"{'Citation': 'Losay J, Touchot A, Capderou A. et al.Aortic valve regurgitation after arterial switch operation for transposition of the great arteries: incidence, risk factors, and outcome. J Am Coll Cardiol. 2006;47(10):2057–2062.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16697325'}}}",
"{'Citation': 'Rickers C, Kheradvar A, Sievers H H. et al.Is the Lecompte technique the last word on transposition of the great arteries repair for all patients? A magnetic resonance imaging study including a spiral technique two decades postoperatively. Interact Cardiovasc Thorac Surg. 2016;22(6):817–825.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC4986772'}, {'@IdType': 'pubmed', '#text': '26920722'}]}}",
"{'Citation': 'Paillole C, Sidi D, Kachaner J. et al.Fate of pulmonary artery after anatomic correction of simple transposition of great arteries in newborn infants. Circulation. 1988;78(4):870–876.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '3168195'}}}"
] | Pol J Radiol. 2016 Dec 19; 81:606-610 | NO-CC CODE |
|
Computed tomographic scan confirming the presence of a high-grade tracheal stenosis (arrow). | 10-1055-s-0035-1556061-i150158crt-1 | 7 | 1197e93ee8a9aef58ba657f31c233e9b67cf977b38b07360eb38e437d9965970 | 10-1055-s-0035-1556061-i150158crt-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
285
] | [{'image_id': '10-1055-s-0035-1556061-i150158crt-1', 'image_file_name': '10-1055-s-0035-1556061-i150158crt-1.jpg', 'image_path': '../data/media_files/PMC5177429/10-1055-s-0035-1556061-i150158crt-1.jpg', 'caption': 'Computed tomographic scan confirming the presence of a high-grade tracheal stenosis (arrow).', 'hash': '1197e93ee8a9aef58ba657f31c233e9b67cf977b38b07360eb38e437d9965970'}, {'image_id': '10-1055-s-0035-1556061-i150158crt-2', 'image_file_name': '10-1055-s-0035-1556061-i150158crt-2.jpg', 'image_path': '../data/media_files/PMC5177429/10-1055-s-0035-1556061-i150158crt-2.jpg', 'caption': 'Established cross-field ventilation with a sterile Woodbridge tube.', 'hash': '0f5ec5af41a05cf5b01f2ae12bca1a5785481dc03747852cf8825f11f744ff5d'}] | {'10-1055-s-0035-1556061-i150158crt-1': ['A 53-year-old man in reasonable overall health (1.75 m/84 kg) was referred to our department with a history of acute coronary syndrome, cardiopulmonary resuscitation, and percutaneous tracheostomy for extended mechanical ventilation over a period of 4 weeks 8 months before admission. He first reported episodes of exertion dyspnea, wheezing, and stridor 3 months after successful decannulation and mild PITS was diagnosed. One month later, an unrelated emergency neurosurgical procedure with a 6.5-mm endotracheal tube (ETT) passing the stenosis and subsequent on-table extubation were described as uneventful despite bronchoscopically confirmed PITS. Because of continuously worsening exertion dyspnea, he underwent endoscopic laser therapy through rigid bronchoscopy under jet ventilation with good results 5 weeks after craniotomy. Unfortunately, his exertion dyspnea worsened over the next 2 months and he finally developed a high-grade tracheal stenosis which was barely passable by fiberoptic bronchoscopy and confirmed through a computed tomographic (CT) scan (<xref rid="10-1055-s-0035-1556061-i150158crt-1" ref-type="fig">Fig. 1</xref>). Our workup at that point conclusively showed a short but high-grade stenosis located well below the cricoid cartilage at the level of the first thoracic vertebra. These findings were further corroborated by body plethysmographic analyses with a specific resistance of 10.25 kPa s (871%) and a total resistance of 1.56 kPa s/L (519%) in accordance with an extrathoracic obstruction and a projected tracheal diameter of 6 to 7 mm.). Our workup at that point conclusively showed a short but high-grade stenosis located well below the cricoid cartilage at the level of the first thoracic vertebra. These findings were further corroborated by body plethysmographic analyses with a specific resistance of 10.25 kPa s (871%) and a total resistance of 1.56 kPa s/L (519%) in accordance with an extrathoracic obstruction and a projected tracheal diameter of 6 to 7 mm.4 We scheduled him for tracheal resection after ascertaining full operability.'], '10-1055-s-0035-1556061-i150158crt-2': ['Anesthesia was continued as total intravenous anesthesia (TIVA) with remifentanil 0.2 µg/kg/min and propofol 4 mg/kg/h. Pressure-controlled ventilation with low inspirational pressure was feasible with minimal leakage. Surgery was performed through a conventional low-collar incision and began with midline-centric dissection of the involved tracheal segments. After localizing the inferior stenosis margin and transecting the trachea, standard cross-field ventilation through a sterile 6.5-mm tube was implemented (<xref rid="10-1055-s-0035-1556061-i150158crt-2" ref-type="fig">Fig. 2</xref>). Because of cricoid involvement, a standard arcuate resection (anterior cricoid cartilage and cartilaginous lower tracheal segment) for laryngotracheal resection was performed. Reconstruction was achieved through lateral tension sutures (3/0 Vicryl, Ethicon/Johnson and Johnson Limited, Norderstedt, Germany) and a running suture (4/0 Maxon, Medtronic, Minneapolis, Minnesota, United States) for membranaceus reconstruction during cross-field ventilation. After switching to orotracheal intubation and placing the tube cuff distally to our involved field, interrupted sutures (2/0 Maxon) completed the cartilaginous aspect of the anastomosis. To avoid inadvertent neck overextension, a chin stitch was placed. Asleep extubation was followed by the bronchoscopic evaluation of anastomotic patency through a reinserted laryngeal mask. After discontinuation of anesthetic drugs and cough-free emergence, the patient was brought to our postanesthesia care unit. Postoperative recovery was uneventful and we could discharge the patient by postoperative day 7 after bronchoscopic control of the anastomosis.). Because of cricoid involvement, a standard arcuate resection (anterior cricoid cartilage and cartilaginous lower tracheal segment) for laryngotracheal resection was performed. Reconstruction was achieved through lateral tension sutures (3/0 Vicryl, Ethicon/Johnson and Johnson Limited, Norderstedt, Germany) and a running suture (4/0 Maxon, Medtronic, Minneapolis, Minnesota, United States) for membranaceus reconstruction during cross-field ventilation. After switching to orotracheal intubation and placing the tube cuff distally to our involved field, interrupted sutures (2/0 Maxon) completed the cartilaginous aspect of the anastomosis. To avoid inadvertent neck overextension, a chin stitch was placed. Asleep extubation was followed by the bronchoscopic evaluation of anastomotic patency through a reinserted laryngeal mask. After discontinuation of anesthetic drugs and cough-free emergence, the patient was brought to our postanesthesia care unit. Postoperative recovery was uneventful and we could discharge the patient by postoperative day 7 after bronchoscopic control of the anastomosis.']} | Airway Management via Laryngeal Mask in Laryngotracheal Resection | [
"thoracic surgery",
"airway management",
"tracheal surgery"
] | Thorac Cardiovasc Surg Rep | 1482566400 | The need for pacemaker and implantable cardioverter defibrillator (ICD) lead revisions and extractions is steadily increasing. Despite the lack of representative studies, the risk of lead extraction is frequently considered to be lower than leaving nonfunctional leads in situ. We report the case of a patient who was referred to our institution for exchange of a malfunctioning ICD lead. The diagnostic work-up revealed a long-segment transmural migration of the ICD lead at the site of the subclavian and innominate vein. Due to the unpredictable risk of vein perforation, we abandoned the extraction procedure. | [] | other | PMC5177429 | null | 18 | [
"{'Citation': 'Kennergren C, Bjurman C, Wiklund R, Gäbel J. A single-centre experience of over one thousand lead extractions. Europace. 2009;11(5):612–617.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2675028'}, {'@IdType': 'pubmed', '#text': '19329797'}]}}",
"{'Citation': 'Deharo J C, Bongiorni M G, Rozkovec A. et al.Pathways for training and accreditation for transvenous lead extraction: a European Heart Rhythm Association position paper. Europace. 2012;14(1):124–134.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22167387'}}}",
"{'Citation': 'Jones S O IV, Eckart R E, Albert C M, Epstein L M. Large, single-center, single-operator experience with transvenous lead extraction: outcomes and changing indications. Heart Rhythm. 2008;5(4):520–525.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18325849'}}}",
"{'Citation': 'Gould P A Krahn A D; Canadian Heart Rhythm Society Working Group on Device Advisories. Complications associated with implantable cardioverter-defibrillator replacement in response to device advisories JAMA 2006295161907–1911.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16639049'}}}",
"{'Citation': 'Lewis R K, Pokorney S D, Greenfield R A. et al.Preprocedural ECG-gated computed tomography for prevention of complications during lead extraction. Pacing Clin Electrophysiol. 2014;37(10):1297–1305.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '25195955'}}}",
"{'Citation': 'Wilkoff B L, Love C J, Byrd C L. et al.Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA) Heart Rhythm. 2009;6(7):1085–1104.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19560098'}}}",
"{'Citation': 'Field M E, Jones S O, Epstein L M. How to select patients for lead extraction. Heart Rhythm. 2007;4(7):978–985.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17599690'}}}",
"{'Citation': 'Maytin M, Epstein L M. The challenges of transvenous lead extraction. Heart. 2011;97(5):425–434.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21296786'}}}",
"{'Citation': 'Buiten M S, van der Heijden A C, Schalij M J, van Erven L. How adequate are the current methods of lead extraction? A review of the efficiency and safety of transvenous lead extraction methods. Europace. 2015;17(5):689–700.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '25687745'}}}",
"{'Citation': 'Maytin M, Wilkoff B L, Brunner M. et al.Multicenter experience with extraction of the Riata/Riata ST ICD lead. Heart Rhythm. 2014;11(9):1613–1618.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '24854215'}}}",
"{'Citation': 'Abi-Saleh B, Refaat M M, Khoury M, Wilkoff B. Conductor externalization of the Biotronik Kentrox internal cardioverter-defibrillator lead: the tip of another iceberg? Heart Rhythm. 2014;11(9):1648–1650.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '24820183'}}}",
"{'Citation': 'Manfredi J A, Smithgall S M, Kircher C M, Lollis M A. Insulation failure with externalized conductor of a Linox SD lead: a case report. J Cardiovasc Electrophysiol. 2014;25(4):440–441.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '24383881'}}}",
"{'Citation': 'Henrikson C A, Leng C T, Yuh D D, Brinker J A. Computed tomography to assess possible cardiac lead perforation. Pacing Clin Electrophysiol. 2006;29(5):509–511.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16689847'}}}",
"{'Citation': 'Marrazzo N, Ugolotti U, Quinto Villani G, Groppi F, Castellini P, Capucci A. Endocardial defibrillation lead extraction: an unusual case of entrapment. Pacing Clin Electrophysiol. 2003;26(10):2036–2038.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14516347'}}}",
"{'Citation': 'Hong S N, Rosenzweig B, Crooke G A, Kronzon I, Srichai M B. Inside and out: an epicardial lead gone astray. Tex Heart Inst J. 2011;38(2):204–205.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3066832'}, {'@IdType': 'pubmed', '#text': '21494539'}]}}",
"{'Citation': 'de Cock C C Vinkers M Van Campe L C Verhorst P M Visser C A Long-term outcome of patients with multiple (> or = 3) noninfected transvenous leads: a clinical and echocardiographic study Pacing Clin Electrophysiol 200023(4, Pt 1):423–426.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10793428'}}}",
"{'Citation': 'van Rooden C J, Molhoek S G, Rosendaal F R, Schalij M J, Meinders A E, Huisman M V. Incidence and risk factors of early venous thrombosis associated with permanent pacemaker leads. J Cardiovasc Electrophysiol. 2004;15(11):1258–1262.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15574174'}}}",
"{'Citation': 'Glikson M, Suleiman M, Luria D M. et al.Do abandoned leads pose risk to implantable cardioverter-defibrillator patients? Heart Rhythm. 2009;6(1):65–68.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19121802'}}}"
] | Thorac Cardiovasc Surg Rep. 2016 Dec 24; 5(1):1-3 | NO-CC CODE |
|
Lateral skull radiograph in a patient with Sturge-Weber syndrome showing parallel cortical calcifications (thin-white arrows). Contrast-enhanced axial T1-weighted MRI showing gyriform contrast enhancement in the right cerebral hemisphere (white arrows). There is brain atrophy on the right side. The cranial vault is asymmetric as secondary to brain atrophy. | poljradiol-79-479-g023 | 7 | 25344feb7283321f406b8c7f0ed5efa90717e5fed8101e14db863742a3b34e94 | poljradiol-79-479-g023.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
480
] | [{'image_id': 'poljradiol-79-479-g008', 'image_file_name': 'poljradiol-79-479-g008.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g008.jpg', 'caption': 'A “giant panda face” is observed in a T2-weighted axial MR image in a case with Wilson syndrome.', 'hash': '7f59c4bac01eb17e8215715edc9d3f84a908ad9be40bc278fb99bab994ea04f7'}, {'image_id': 'poljradiol-79-479-g006', 'image_file_name': 'poljradiol-79-479-g006.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g006.jpg', 'caption': '”Molar tooth sign” (star) at the level of pons and superior cerebellar peduncles coursing parallel to each other (white arrows) is seen in a T1-weighted MR section in a case with Joubert syndrome.', 'hash': '34e788dbd21b84ff0b6c20944366800a539eeb9e3557180b6860fcd7c6ad413c'}, {'image_id': 'poljradiol-79-479-g001', 'image_file_name': 'poljradiol-79-479-g001.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g001.jpg', 'caption': 'High resolution, axial CT image demonstrating the “ice-cream sign” of the temporal bone (white arrow). The sign represents the typical appearance of the malleoincudal joint.', 'hash': '19b42cbf91d43bdb64b42cd16e12e37ffcc5e87de6afbd011f77c2e7f2317dd0'}, {'image_id': 'poljradiol-79-479-g022', 'image_file_name': 'poljradiol-79-479-g022.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g022.jpg', 'caption': 'Coronal view of MRI head of the patient demonstrating the lateral ventricles forming a “Viking helmet” appearance (white arrows) due to the absence of corpus callosum (black arrow).', 'hash': 'eca10cadf823458b59a36edc7a99b2f38473e1a9fc9c1e4fc0de4093b758ed65'}, {'image_id': 'poljradiol-79-479-g025', 'image_file_name': 'poljradiol-79-479-g025.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g025.jpg', 'caption': 'Axial T2-weighted MRI image at the level of the pontomedullary junction demonstrating the 4th ventricle that is shaped like a “bat wing” (arrow). In addition, axial T2-weighted MR image showing molar tooth sign (arrow).', 'hash': '6eee25bf3510cc719490eb2e14315af77a3f7c181d0999f6df1278f508db2ac2'}, {'image_id': 'poljradiol-79-479-g010', 'image_file_name': 'poljradiol-79-479-g010.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g010.jpg', 'caption': 'A “tigroid appearance” is observed at periventricular white matter in axial T2-weighted MR sections in a 2-year-old girl with metachromatic leukodystrophy.', 'hash': 'ddd48ccb29a7d4997505deaf50f679c202b4745d972b6546203fb365d738ed83'}, {'image_id': 'poljradiol-79-479-g017', 'image_file_name': 'poljradiol-79-479-g017.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g017.jpg', 'caption': 'Axial T2-weighted MR image showing an “angel wing appearance” in the brainstem (black arrows).', 'hash': '61a796b6a550ad7bbf9d4419f025bb51eb2cd8c64edc5b966b57dfea4438b489'}, {'image_id': 'poljradiol-79-479-g019', 'image_file_name': 'poljradiol-79-479-g019.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g019.jpg', 'caption': 'Sagittal T1-weighted MRI demonstrating a small posterior fossa with a low-lying tentorial attachment posteriorly. The tectum is beaked (white arrow) and partial corpus callosum agenesis is present.', 'hash': '1096f44584e4a1c08a7412a35d90c5e9c6e94ef22e00cb7e263a785363352122'}, {'image_id': 'poljradiol-79-479-g007', 'image_file_name': 'poljradiol-79-479-g007.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g007.jpg', 'caption': 'An appearance similar to “figure eight” due to lissencephaly in the axial plane on CT examination.', 'hash': 'e3046ffa02a986120b02582bb35dbdda57578ece4cc77517605af05209219f68'}, {'image_id': 'poljradiol-79-479-g009', 'image_file_name': 'poljradiol-79-479-g009.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g009.jpg', 'caption': 'Hyperintense radial bands (black arrow) extending linearly at the level of the right cerebral hemisphere and a cortical tuber (short white arrow) located at the left parietal lobe in an axial FLAIR MR image in a case with tuberous sclerosis complex. In addition, MRI showing a subependymal nodule (thin black arrow).', 'hash': 'f1f172f21575228cfe087330a9464ffb74ee695c1a44fa32c46f50de8fafeab4'}, {'image_id': 'poljradiol-79-479-g018', 'image_file_name': 'poljradiol-79-479-g018.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g018.jpg', 'caption': 'Sagittal T2-weigted MRI images showing a nidus of compact vessel with a typical appearance of “bag of black worms” in the left frontal region (white arrows).', 'hash': 'd9f28ec0d15c1383841691af82872867b7010a3160ff790b78052f2cd02474bd'}, {'image_id': 'poljradiol-79-479-g016', 'image_file_name': 'poljradiol-79-479-g016.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g016.jpg', 'caption': 'Contrast-enhanced T1-weighted axial MR image confirming converging tubular structures that represent a venous angioma (white arrow) in the medial aspect of the right cerebellar lobe.', 'hash': '556a81b565034f9b5a1721423d20693dbeb7597bf475f053ec82bde4716155ea'}, {'image_id': 'poljradiol-79-479-g011', 'image_file_name': 'poljradiol-79-479-g011.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g011.jpg', 'caption': 'Post-contrast T1-weighted MR image showing an incomplete ring lesion enhancing in the right parietal region (black arrow).', 'hash': '106370c35eff0b059753c3b5890462ab5b90513151835a6b5107cfeff58078aa'}, {'image_id': 'poljradiol-79-479-g024', 'image_file_name': 'poljradiol-79-479-g024.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g024.jpg', 'caption': 'Axial T2-weighted MRI at the level of the posterior fossa showing antero-posterior elongation of the fourth ventricle giving it a “diamond shaped” appearance (arrows).', 'hash': 'bacaee48757ebe5fe2c85f7d9ba39e52c8ab3c0842055bc62191b726ebcbc002'}, {'image_id': 'poljradiol-79-479-g023', 'image_file_name': 'poljradiol-79-479-g023.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g023.jpg', 'caption': 'Lateral skull radiograph in a patient with Sturge-Weber syndrome showing parallel cortical calcifications (thin-white arrows). Contrast-enhanced axial T1-weighted MRI showing gyriform contrast enhancement in the right cerebral hemisphere (white arrows). There is brain atrophy on the right side. The cranial vault is asymmetric as secondary to brain atrophy.', 'hash': '25344feb7283321f406b8c7f0ed5efa90717e5fed8101e14db863742a3b34e94'}, {'image_id': 'poljradiol-79-479-g012', 'image_file_name': 'poljradiol-79-479-g012.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g012.jpg', 'caption': 'The b=1000 s/mm2 DWI showing an acute infarct as “light bulb” bright.', 'hash': '1adaa586a794fa1b1f7bf3c1dbf53c34d4889a25ad9cc28551982f4443cefced'}, {'image_id': 'poljradiol-79-479-g015', 'image_file_name': 'poljradiol-79-479-g015.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g015.jpg', 'caption': 'Post-contrast axial CT image showing the cortical veins (black arrows).', 'hash': '79067663971e2dfe70ed6e500b56be7b3fb4f492eae6cbf7d7e9c215128d333e'}, {'image_id': 'poljradiol-79-479-g020', 'image_file_name': 'poljradiol-79-479-g020.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g020.jpg', 'caption': 'Axial T2-weighted MR image showing four layers consisting of cortex, thin outer white matter, diffuse subcortical heterotopia, and inner white matter around the lateral ventricles, giving the appearance of a “double cortex”', 'hash': '9d3fd4b0c1b19068f61f37a691f0bda3c0ccc15642b32de9d7c60f9038e1cea5'}, {'image_id': 'poljradiol-79-479-g027', 'image_file_name': 'poljradiol-79-479-g027.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g027.jpg', 'caption': 'Fetal MR images demonstrating absent cranial bone/brain and bulging orbits (arrows). In addition, polyhydramnios is seen (star).', 'hash': '86ce46606f7efcc05017bd631c2b396fc859db08b021adb00c5625c4c7331d8f'}, {'image_id': 'poljradiol-79-479-g004', 'image_file_name': 'poljradiol-79-479-g004.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g004.jpg', 'caption': '”Lemon sign” is seen in the frontal bones in a fetus with myeloschisis, as detected in an obstetrical US performed at the 20th week of gestation (white arrows).', 'hash': 'e73ae209e708123ca3bb5f94d30b2bbf2ae0c6a71d48877d5928b1b610fb9972'}, {'image_id': 'poljradiol-79-479-g003', 'image_file_name': 'poljradiol-79-479-g003.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g003.jpg', 'caption': '”Mount Fuji sign” due to tension pneumocephalus is observed in axial CT sections (parenchymal and bone window, white arrows)', 'hash': 'cd150d511a996a5b01c1b7853e60cf0af1204aa40f32ee496fe45a76b7c48e7b'}, {'image_id': 'poljradiol-79-479-g028', 'image_file_name': 'poljradiol-79-479-g028.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g028.jpg', 'caption': 'Axial T2-weighted MR image showing bilateral atrophy of caudate nuclei and compensatory dilatation of lateral ventricles, a finding known as “boxcar ventricle” (black arrow).', 'hash': '24735098411b152bc6ef75c0ac85e88322a6f867999988055923e9c07e40e086'}, {'image_id': 'poljradiol-79-479-g026', 'image_file_name': 'poljradiol-79-479-g026.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g026.jpg', 'caption': 'Axial T1-weighted and T2-weighted images demonstrating widened sylvian fissures producing “bat-wings” appearance (arrows and stars).', 'hash': '45bce2f6fa928f2202f95535ec96a4f2e81e85a5d46abbad0f5c8eaa8442df1b'}, {'image_id': 'poljradiol-79-479-g021', 'image_file_name': 'poljradiol-79-479-g021.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g021.jpg', 'caption': 'Transverse US image showing small posterior fossa and banana-shaped cerebellum (“banana sign”) (black arrows.', 'hash': '2e845e5ca1c61cd1d0bdc891d6cc06d210fd4676c844c6d84f93d40496e32286'}, {'image_id': 'poljradiol-79-479-g014', 'image_file_name': 'poljradiol-79-479-g014.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g014.jpg', 'caption': 'Axial and parasagittal FLAIR MR images demonstrating multiple sclerosis plaques extending up through the corpus callosum (thin black arrows).', 'hash': '24f548e44ff440cca03fea9496aca29596de6449a68988ea84dab1c260c11816'}, {'image_id': 'poljradiol-79-479-g013', 'image_file_name': 'poljradiol-79-479-g013.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g013.jpg', 'caption': 'Axial non-contrast CT image showing typical “key-hole” appearance of cisterna magna communicating with a dilated 4th ventricle (star).', 'hash': 'd5258ba5b362df922693a351a797366b0c0f554b284538a5f092c05f57ba5b55'}, {'image_id': 'poljradiol-79-479-g002', 'image_file_name': 'poljradiol-79-479-g002.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g002.jpg', 'caption': '”CT reversal sign” is observed due to diffuse cerebral anoxia in non-contrasted CT examination.', 'hash': 'cc98322881bfb0bc94f3ec568cf963a41d1fd5a45397a4d77e8844ce9e29f3d3'}, {'image_id': 'poljradiol-79-479-g005', 'image_file_name': 'poljradiol-79-479-g005.jpg', 'image_path': '../data/media_files/PMC4274733/poljradiol-79-479-g005.jpg', 'caption': '”Pancake brain appearance” formed by monoventricle cavity and cerebral hemispheric fusion is seen in T1-weighted MR image in a case with alobar holoprozencephaly.', 'hash': '3615cd191d6929a718b01dcc3476469d6ec8e12c9b746b474cac1dde12ed3d8e'}] | {'poljradiol-79-479-g001': ['It reflects normal appearance of incudomalleolar joint formed by malleolar head and body of the incus on axial computed tomography (CT) sections (<xref ref-type="fig" rid="poljradiol-79-479-g001">Figure 1</xref>). Anatomical identification of this anatomic structure is important in terms of ossicular luxation especially in trauma cases. The space between the ice-cream cone and the scutum is called Prussak’s space [). Anatomical identification of this anatomic structure is important in terms of ossicular luxation especially in trauma cases. The space between the ice-cream cone and the scutum is called Prussak’s space [1].'], 'poljradiol-79-479-g002': ['The reversal sign is associated with diffuse anoxic-ischemic brain damage and almost always observed in children (<xref ref-type="fig" rid="poljradiol-79-479-g002">Figure 2</xref>). This sign is characterized by a relative reversal of the attenuation between supra- and infratentorial structures. The grey-white matter distinction is lost and decreased, and there is a diffuse decrease in density in the cerebral grey and white matter. Thalami, brainstem, and cerebellum have a relatively increased density. It is closely related to child abuse, especially when accompanying intracranial bleeding [). This sign is characterized by a relative reversal of the attenuation between supra- and infratentorial structures. The grey-white matter distinction is lost and decreased, and there is a diffuse decrease in density in the cerebral grey and white matter. Thalami, brainstem, and cerebellum have a relatively increased density. It is closely related to child abuse, especially when accompanying intracranial bleeding [1,2].'], 'poljradiol-79-479-g003': ['This sign is observed in bilateral subdural tension pneumocephalus. These air accumulations lead to compression in the frontal lobes and take a form of Mount Fuji on axial CT sections (<xref ref-type="fig" rid="poljradiol-79-479-g003">Figure 3</xref>). It is most commonly seen after surgical decompression of chronic subdural hematoma. However, it may also be observed following a head trauma, otogenic infections, nitrous oxide anesthesia, and diving [). It is most commonly seen after surgical decompression of chronic subdural hematoma. However, it may also be observed following a head trauma, otogenic infections, nitrous oxide anesthesia, and diving [3].'], 'poljradiol-79-479-g004': ['The lemon sign is useful in identification of spina bifida and is commonly associated with hydrocephalus and Chiari II malformation. Loss of normal convex contour of the frontal bones in transverse fetal sonogram obtained at biparietal diameter (<xref ref-type="fig" rid="poljradiol-79-479-g004">Figure 4</xref>). It has a high sensitivity and specifity in high-risk patients before the 24). It has a high sensitivity and specifity in high-risk patients before the 24th gestational week. However, it is not specific for spina bifida and may be detected in encephalocele, Dandy-Walker malformation, thanatophoric dysplasia, cystic hygroma, corpus callosum agenesis, hydronephrosis, and umbilical vein varices [4].'], 'poljradiol-79-479-g005': ['This sign defines the appearance of abnormal brain tissue in cases with alobar holoprosencephaly. Holoprosencephaly is an anomaly caused by a prosencephalic division defect and characterized by varying degrees of fusion of cerebellar hemispheres, diencephalon, basal ganglia, and thalami. The pancake brain sign is formed by fusion of cerebral hemispheres associated with the presence of typical monoventricle at the center (<xref ref-type="fig" rid="poljradiol-79-479-g005">Figure 5</xref>) 1].) 1].'], 'poljradiol-79-479-g006': ['Joubert syndrome is an autosomal recessive disorder characterized by abnormal eye movements, nystagmus, and difficulty in following mobile objects with eyes, apnea-tachypnea episodes, and motor retardation. Molar tooth sign represents abnormal antero-posterior orientation of superior cerebellar peduncles in a way similar to stems of a molar tooth on axial CT or magnetic resonance (MR) images (<xref ref-type="fig" rid="poljradiol-79-479-g006">Figure 6</xref>). It is mainly observed in patients with Joubert syndrome [). It is mainly observed in patients with Joubert syndrome [5,6].'], 'poljradiol-79-479-g007': ['Lissencephaly is a disorder caused by defective neuronal migration between the 8–14th gestational week and characterized by a lack of development of gyri and sulci. Lissencephaly is classified into two subgroups: complete (type 1 – agyria) or partial (type 2 – pachygyria). Type 1 lissencephaly is characterized by shallow sylvian fissures that are vertically oriented. In this type of lissencephaly, brain takes on an hour-glass or figure-8 appearance due to compression at the middle part by sylvian fissures on axial imaging (<xref ref-type="fig" rid="poljradiol-79-479-g007">Figure 7</xref>) [) [7].'], 'poljradiol-79-479-g008': ['This sign was first described by Hitoshi et al. in Wilson’s disease in 1991. It consists of high signal intensity in the tegmentum except for the red nucleus, preservation of signal intensity at the lateral portion of the pars reticulata of the substantia nigra, and hypointensity of the superior colliculus (<xref ref-type="fig" rid="poljradiol-79-479-g008">Figure 8</xref>). The real pathology responsible for this appearance is the paramagnetic effect of the accumulation of heavy metals such as iron and copper in affected sites [). The real pathology responsible for this appearance is the paramagnetic effect of the accumulation of heavy metals such as iron and copper in affected sites [8,9].'], 'poljradiol-79-479-g009': ['Radial bands are linear or curvilinear areas with an abnormal signal intensity extending from the periventricular region to the subcortical region, that are best observed on T2-weighted (T2W) and especially FLAIR MR images (<xref ref-type="fig" rid="poljradiol-79-479-g009">Figure 9</xref>). It is believed that radial band sign is indicative of abnormal migration of dysplastic stem cells during the course of radial glial-neuronal unit in patients with tuberous sclerosis complex. Radial bands are hypo-/isointense on T1-weighted images and hyperintense on T2W and FLAIR images [). It is believed that radial band sign is indicative of abnormal migration of dysplastic stem cells during the course of radial glial-neuronal unit in patients with tuberous sclerosis complex. Radial bands are hypo-/isointense on T1-weighted images and hyperintense on T2W and FLAIR images [10].'], 'poljradiol-79-479-g010': ['This sign is characterized by multiple dark spots or stripes (spared perivascular white matter) of normal white matter intensity scattered within the bright demyelinated periventricular white matter on T2W images (<xref ref-type="fig" rid="poljradiol-79-479-g010">Figure 10</xref>). Tigroid appearance of the white mater has been found in some cases with Pelizaeus-Merzbacher disease and metachromatic leukodystrophy. However, it has been recently reported that it may be observed in cases with lissencephaly accompanied by cerebellar hypoplasia [). Tigroid appearance of the white mater has been found in some cases with Pelizaeus-Merzbacher disease and metachromatic leukodystrophy. However, it has been recently reported that it may be observed in cases with lissencephaly accompanied by cerebellar hypoplasia [11,12].'], 'poljradiol-79-479-g011': ['The open ring sign is a relatively specific sign for demyelination, helpful in distinguishing between ring enhancing lesions. It is observed in patients with multiple sclerosis. It is observed as a lesion showing contrast effect as a circle that incompletely encircles a demyelinated plaque. The lesion is a high-intensity one on T2W images and it may be difficult to distinguish from an abscess or astrocytoma in this form (<xref ref-type="fig" rid="poljradiol-79-479-g011">Figure 11</xref>) [) [13,14].'], 'poljradiol-79-479-g012': ['Diffusion-weighted (DW) MR imaging is the method that can delineate ischemic lesions in the brain at the earliest stage. With the help of this method, this lesion can be demonstrated after the onset of the event. The ischemic area shines like a light bulb at this stage (it appears darker on ADC images) (<xref ref-type="fig" rid="poljradiol-79-479-g012">Figure 12</xref>). This area forms the core of the infarcted region. The brightness diminishes by the 2). This area forms the core of the infarcted region. The brightness diminishes by the 2nd–3rd month. In this way, acute and chronic infracts can be distinguished or acute lesions can be defined in patients with multiple lesions of varying age. The marked increase in DWI signal in areas of acute ischemia, relative to unaffected brain, is typically so striking that this finding has been referred to as the “light bulb sign” of acute stroke [15].'], 'poljradiol-79-479-g013': ['The posterior fossa dimensions are normal in Dandy-Walker variants. There is a mild vermian hypoplasia and thus the vallecula becomes widened between the cerebellar hemispheres under the vermis. The fourth ventricle and cisterna magna communicate with each other through this wide vallecula. This appearance on axial CT and MR images is called “keyhole sign” (<xref ref-type="fig" rid="poljradiol-79-479-g013">Figure 13</xref>) [) [16].'], 'poljradiol-79-479-g014': ['It is detected on MR examination in multiple sclerosis. Demyelinating plaques are observed as focal signal areas on proton density and T2W MR images (<xref ref-type="fig" rid="poljradiol-79-479-g014">Figure 14</xref>). These plaques are round or ovoid lesions limited particularly to the periventricular region. The appearance of periventricularly located ovoid lesions in the extended form along the ventricle is called Dawson finger [). These plaques are round or ovoid lesions limited particularly to the periventricular region. The appearance of periventricularly located ovoid lesions in the extended form along the ventricle is called Dawson finger [17].'], 'poljradiol-79-479-g015': ['This was first described in MRI and also reported later on US and CT. It is used to differentiate extra-axial subarachnoid and subdural effusions from each other. On both CT and MRI, bridging veins extend from the cortical surface to the arachnoid (<xref ref-type="fig" rid="poljradiol-79-479-g015">Figure 15</xref>). Appearance of bridging veins coursing in that manner in the extra-axial fluid is called a positive cortical vein sign and indicates that the fluid is located subarachnoidally. The fluid is located subdurally when these veins are invisible [). Appearance of bridging veins coursing in that manner in the extra-axial fluid is called a positive cortical vein sign and indicates that the fluid is located subarachnoidally. The fluid is located subdurally when these veins are invisible [18].'], 'poljradiol-79-479-g016': ['The most common vascular malformation in the bran is venous angiomas. They are most commonly observed in the frontal lobe and the posterior fossa. It has been suggested that they stem from a pause during brain development, i.e. when the arterial system completes its development but the venous system is not fully developed yet. The caput medusa sign, also known as a palm tree sign, refers to developmental venous anomalies of the brain, where a number of veins drain centrally towards a single drain vein. (<xref ref-type="fig" rid="poljradiol-79-479-g016">Figure 16</xref>). The appearance is reminiscent of Medusa, a gorgon of Greek mythology, who was encountered and defeated by Perseus. The sign is seen on both CT and MRI when contrast is administered [). The appearance is reminiscent of Medusa, a gorgon of Greek mythology, who was encountered and defeated by Perseus. The sign is seen on both CT and MRI when contrast is administered [19,20].'], 'poljradiol-79-479-g017': ['Chiari type II is the most common type of Chiari malformation. It is also known as Arnold-Chiari malformation. In 90% of cases there is also myelomeningocele, hydrocephalus, and corpus callosum agenesis. In these cases, prepontine migration of the cerebellum at the level of the middle cerebellar peduncle gives the brainstem an angel wing appearance on axial MR images (<xref ref-type="fig" rid="poljradiol-79-479-g017">Figure 17</xref>) [) [21].'], 'poljradiol-79-479-g018': ['Arteriovenous malformations are space-occupying lesions formed by conglomerated large vessels. There may sometimes be a very small amount of brain tissue between the vessels in intracranial arteriovenous malformations. There is no brain tissue at all in some cases. Thus, such an appearance of large vessels resembles clustered worms and is called a worm bag sign (<xref ref-type="fig" rid="poljradiol-79-479-g018">Figure 18</xref>) [) [22].'], 'poljradiol-79-479-g019': ['Chiari type II is the most common type of Chiari malformation. It is also known as Arnold-Chiari malformation. In 90% of cases there is also myelomeningocele, hydrocephalus, and corpus callosum agenesis. Variable degrees of fusion of the colliculi and tectum result in prominent beaking and inferior displacement of the tectal plate. In these cases, the appearance of the pointed tectum is called tectal beaking (<xref ref-type="fig" rid="poljradiol-79-479-g019">Figure 19</xref>) [) [21].'], 'poljradiol-79-479-g020': ['Because of the early arrest of neuronal migration, a symmetric circumferential band of heterotopic grey matter is separated from the overlying cortex by a thin band of white matter. On MRI, the brain appears to have a “double cortex” appearance (<xref ref-type="fig" rid="poljradiol-79-479-g020">Figure 20</xref>). The condition is quite rare, found predominantly in females, and is occasionally associated with an X-linked dominant inheritance pattern [). The condition is quite rare, found predominantly in females, and is occasionally associated with an X-linked dominant inheritance pattern [23].'], 'poljradiol-79-479-g021': ['The banana cerebellum sign is one of the many notable fruit-inspired signs, such as the “lemon sign”. In neural tube defects, folding of the cerebellum around the posterior brain stem due to inferior traction of the spinal cord causes the cerebellum to take the form of a banana. It has been reported that it may be present in 57% of fetuses with neural tube defect. In fetal hydrocephalus, a cerebellar deformation is observed in conjunction with ventriculomegaly and deletion of cisterna magna. In these cases, the cerebellum loses its normal central convexity and becomes compressed parallelly to the occipital bone, resembling a banana (<xref ref-type="fig" rid="poljradiol-79-479-g021">Figure 21</xref>) [) [24].'], 'poljradiol-79-479-g022': ['The “Viking helmet” appearance refers to the lateral ventricles in the coronal projection in patients with dysgenesis of the corpus callosum. The cingulate gyrus is everted into narrowed and elongated frontal horns (<xref ref-type="fig" rid="poljradiol-79-479-g022">Figure 22</xref>). Dysgenesis of the corpus callosum may be complete (agenesis) or partial and represents an “in utero” developmental anomaly [). Dysgenesis of the corpus callosum may be complete (agenesis) or partial and represents an “in utero” developmental anomaly [25,26].'], 'poljradiol-79-479-g023': ['The tram-track sign is seen on skull radiographs as gyriform, curvilinear, parallel opacities that have the appearance of calcifications (<xref ref-type="fig" rid="poljradiol-79-479-g023">Figure 23</xref>). A similar appearance can be seen on CTs. Sturge-Weber syndrome is a rare neurocutaneous syndrome that includes a facial port-wine stain and is associated with leptomeningeal angiomatosis. Weber demonstrated the characteristic gyriform intracranial calcifications. Calcifications are often gyriform and curvilinear and are most common in the parietal and occipital lobes. Calcifications can be more extensive but with frontal lobe and/or bilateral involvement. CT scans show calcifications in the areas of atrophy [). A similar appearance can be seen on CTs. Sturge-Weber syndrome is a rare neurocutaneous syndrome that includes a facial port-wine stain and is associated with leptomeningeal angiomatosis. Weber demonstrated the characteristic gyriform intracranial calcifications. Calcifications are often gyriform and curvilinear and are most common in the parietal and occipital lobes. Calcifications can be more extensive but with frontal lobe and/or bilateral involvement. CT scans show calcifications in the areas of atrophy [27].'], 'poljradiol-79-479-g024': ['This appearance is seen in rhombencephalosynapsis. Rhombencephalosynapsis is a rare condition with most cases found in newborns and infants. Morphological findings are predominantly characterized by fusion of the cerebellar hemispheres and absence of the vermis, often accompanied by supratentorial anomalies. The size of the fourth ventricle is variable and in its axial plane it usually has a “keyhole or diamond shape” (<xref ref-type="fig" rid="poljradiol-79-479-g024">Figure 24</xref>). This appearance is a result of dorsal and rostral convergence of the dentate nuclei, cerebellar peduncles and inferior colliculi [). This appearance is a result of dorsal and rostral convergence of the dentate nuclei, cerebellar peduncles and inferior colliculi [28].'], 'poljradiol-79-479-g025': ['Bat wing 4th ventricle sign refers to the morphology of the fourth ventricle in the Joubert anomaly and related syndromes. The absence of the vermis with apposed cerebellar hemispheres give the fourth ventricle an appearance reminiscent of a bat with its wings outstretched. It is best demonstrated in axial imaging (<xref ref-type="fig" rid="poljradiol-79-479-g025">Figure 25</xref>) and could be easily missed in sagittal and coronal images [) and could be easily missed in sagittal and coronal images [29].'], 'poljradiol-79-479-g026': ['Glutaric aciduria type 1 (GA-1) is an autosomal recessive inborn error of lysine, hydroxylysine and tryptophan metabolism that results from a deficiency of glutaryl-CoA dehydrogenase. The most striking finding on brain imaging is the presence of very wide CSF spaces anterior to the temporal lobes and within the sylvian fissures (giving a “bat wing” appearance). Widening of the sylvian fissures is a very characteristic finding in glutaric aciduria type I (<xref ref-type="fig" rid="poljradiol-79-479-g026">Figure 26</xref>) [) [30].'], 'poljradiol-79-479-g027': ['Anencephaly is the most severe form of cranial neural tube defects (NTD) and is characterized by the absence of cortical tissue (although the brainstem and the cerebellum may be present) or cranial vault. Morphological spectrum within anencephaly ranges from holocrania (severest form) to merocrania (mildest form). Anencephaly may be radiologically detectable as early as at 11 weeks. A “frog eye” appearance may be seen in the coronal plane of US or MR images due to an absent cranial bone or brain, and bulging orbits (<xref ref-type="fig" rid="poljradiol-79-479-g027">Figure 27</xref>) [) [31].'], 'poljradiol-79-479-g028': ['Huntington’s disease is an autosomal dominant neurodegenerative disease, especially common in young adults. It has a course characterized by cognitive, behavioral, and muscle coordination disorders. In these cases, there may be an atrophy in basal ganglia, particularly in the caudate nucleus. Consequently, a widening may be seen in the frontal horns of the lateral ventricle. This particular appearance of frontal horns on multiplanar MR sections is called boxcar ventricle sign (<xref ref-type="fig" rid="poljradiol-79-479-g028">Figure 28</xref>) [) [32].']} | Classical Signs and Appearances in Pediatric Neuroradiology: A Pictorial Review | [
"Brain Diseases, Metabolic",
"Magnetic Resonance Imaging, Cine",
"Multidetector Computed Tomography",
"Nervous System Malformations"
] | Pol J Radiol | 1419148800 | Radiological practice includes classification of illnesses with similar characteristics through recognizable signs. In this report, twenty-eight important and frequently seen neuroradiological signs in childhood are presented and described using X-rays, computed tomography (CT), magnetic resonance (MR) images, illustrations and photographs. | [] | other | PMC4274733 | null | 32 | [
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"{'Citation': 'Jang U, Lee K, Shim J, et al. Diagnostic value of the cortical vein sign: unreliable index of atrophy on MR image. J Kor Neurotraumatol Soc. 2006;2:13–17.'}",
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] | Pol J Radiol. 2014 Dec 21; 79:479-489 | NO-CC CODE |
|
A) Sagittal multiplanar reconstruction (MPR) revealing the dimensions of the bladder. We can observe the loops of the large intestine dilated above the bladder. There was no associated dilation of the small intestine. We observed an anterior interposition of the colonic loops to the liver (Chilaiditi syndrome). B) Sagittal MPR revealing an abrupt change in the calibre of the sigmoid colon (yellow arrowhead). C) Axial MPR identifying pyeloureteral dilation compatible with grade III hydronephrosis. | gr1_lrg | 7 | 6ce2d042a9d4a272075dc3bfdef57593c1f8d034595c5747651182bc295a6710 | gr1_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
732,
372
] | [{'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC10036306/gr1_lrg.jpg', 'caption': 'A) Sagittal multiplanar reconstruction (MPR) revealing the dimensions of the bladder. We can observe the loops of the large intestine dilated above the bladder. There was no associated dilation of the small intestine. We observed an anterior interposition of the colonic loops to the liver (Chilaiditi syndrome). B) Sagittal MPR revealing an abrupt change in the calibre of the sigmoid colon (yellow arrowhead). C) Axial MPR identifying pyeloureteral dilation compatible with grade III hydronephrosis.', 'hash': '6ce2d042a9d4a272075dc3bfdef57593c1f8d034595c5747651182bc295a6710'}] | {'gr1_lrg': ['A 72-year-old male with no previous medical history or treatment came to the emergency department after two weeks of symptoms of cough, dyspnoea, asthenia, abdominal pain, and oliguria. He was dehydrated, afebrile, normotensive, and presented signs of an acute abdomen. Laboratory tests revealed acute kidney failure with a serum creatinine of 11.3\u202fmg/dl and urea of 354\u202fmg/dl, metabolic acidosis, elevation of the anion gap that presented (venous sample, so the respiratory compensation was not estimable: pH 7.24, bicarbonate 16\u202fmmol/l and carbon dioxide 39\u202fmmHg, anion gap 22\u202fmEq/l), lactate 2\u202fmmol/l and negative urine ketones. There was no ingestion of toxins or any type of medication. Routine d-lactic acid was not requested. The rest of the lytes were: potassium 4.1\u202fmmol/l, sodium 127\u202fmmol/l, chloride 89\u202fmmol/l, phosphorus 12.2\u202fmg/dl and calcium corrected for albumin was 10.6\u202fmg/dl. Lymphopenia was 500\u202f×\u202f103/l, C-reactive protein (CRP) 134\u202fmg/l and D-dimer\u202f>\u202f80,000\u202fg/l. Prior to admission, laboratory tests were normal. Magnesium, requested 48\u202fh following admission, was normal. There was no ingestion of toxins and did not receive any type of medication. A non-contrast-enhanced abdominal computed tomography (CT) scan revealed a significant bladder dilation of 20.2\u202f×\u202f10.3\u202f×\u202f11.8\u202fcm (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>\nA) with bilateral hydronephrosis. The considerable bladder distension compressed the rectum and sigmoid colon against the sacrum (\nA) with bilateral hydronephrosis. The considerable bladder distension compressed the rectum and sigmoid colon against the sacrum (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>B) causing an obstructive ileus with distension of the entire colon. No wall thickening or irregularity of the colon section was observed. The patient did not report any previous history of urological or G.I. abnormalities prior to admission.B) causing an obstructive ileus with distension of the entire colon. No wall thickening or irregularity of the colon section was observed. The patient did not report any previous history of urological or G.I. abnormalities prior to admission.Figure 1A) Sagittal multiplanar reconstruction (MPR) revealing the dimensions of the bladder. We can observe the loops of the large intestine dilated above the bladder. There was no associated dilation of the small intestine. We observed an anterior interposition of the colonic loops to the liver (Chilaiditi syndrome). B) Sagittal MPR revealing an abrupt change in the calibre of the sigmoid colon (yellow arrowhead). C) Axial MPR identifying pyeloureteral dilation compatible with grade III hydronephrosis.Figure 1', 'For all these reasons, the patient was diagnosed with acute obstructive renal failure, likely of infravesical origin with grade III bilateral hydronephrosis (<xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>C) and intestinal obstruction secondary to the compression exerted by the bladder. After bladder catheterisation, fluid and electrolyte replacement, and initiation of treatment with tamsulosin, renal function returned to normal. In addition, COVID-19 pneumonia was diagnosed and treated with azithromycin and hydroxychloroquine. These are two common pathologies (acute obstructive renal failure and intestinal obstruction), but they rarely appear together, having a simple and non-surgical treatment. In this case, the hydroelectrolytic disorders did not justify the episode of obstructive renal failure, and it was attributed to a possible prostatic origin. On discharge, the patient was referred to urology for complete evaluation with imaging and urodynamic studies. The bladder distension obtained is striking, suggesting that, apart from the possibility of an underlying prostate pathology, there may be also some type of co-existing bladder dysfunction. It is important to highlight that the SARS-CoV-2 epidemiological situation made the patient to come late to the hospital emergency room, with the identification of a case, both remarkable and uncommon, of advanced obstructive renal failure with the secondary intestinal complication.C) and intestinal obstruction secondary to the compression exerted by the bladder. After bladder catheterisation, fluid and electrolyte replacement, and initiation of treatment with tamsulosin, renal function returned to normal. In addition, COVID-19 pneumonia was diagnosed and treated with azithromycin and hydroxychloroquine. These are two common pathologies (acute obstructive renal failure and intestinal obstruction), but they rarely appear together, having a simple and non-surgical treatment. In this case, the hydroelectrolytic disorders did not justify the episode of obstructive renal failure, and it was attributed to a possible prostatic origin. On discharge, the patient was referred to urology for complete evaluation with imaging and urodynamic studies. The bladder distension obtained is striking, suggesting that, apart from the possibility of an underlying prostate pathology, there may be also some type of co-existing bladder dysfunction. It is important to highlight that the SARS-CoV-2 epidemiological situation made the patient to come late to the hospital emergency room, with the identification of a case, both remarkable and uncommon, of advanced obstructive renal failure with the secondary intestinal complication.']} | A curious case of acute kidney failure in times of COVID-19 | null | Nefrologia (Engl Ed) | 1679641200 | None | null | other | PMC10036306 | null | null | [
""
] | Nefrologia (Engl Ed). 2023 Mar 24 January-February; 43(1):158-159 | NO-CC CODE |
|
Computed tomography scan of the abdomen and pelvis 2 hours postinjury demonstrating pneumoperitoneum (arrows) on axial and sagittal cross sections, consistent with hollow organ perforation. | 10.1177_1941738118796130-fig1 | 7 | a4ad6f453d7d239b8aa4d838ee48cc43b9ccb92121a70b881a7b3f626043cbde | 10.1177_1941738118796130-fig1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
606,
377
] | [{'image_id': '10.1177_1941738118796130-fig1', 'image_file_name': '10.1177_1941738118796130-fig1.jpg', 'image_path': '../data/media_files/PMC6204643/10.1177_1941738118796130-fig1.jpg', 'caption': 'Computed tomography scan of the abdomen and pelvis 2 hours postinjury demonstrating pneumoperitoneum (arrows) on axial and sagittal cross sections, consistent with hollow organ perforation.', 'hash': 'a4ad6f453d7d239b8aa4d838ee48cc43b9ccb92121a70b881a7b3f626043cbde'}, {'image_id': '10.1177_1941738118796130-fig2', 'image_file_name': '10.1177_1941738118796130-fig2.jpg', 'image_path': '../data/media_files/PMC6204643/10.1177_1941738118796130-fig2.jpg', 'caption': 'Correct patient position and technique for the Carnett sign. The provider presses on point of maximum tenderness while the patient contracts the abdominal muscles by lifting legs and torso off the examination table.', 'hash': '09e2b8c94b75a2edb951fdebf776094c40d87ae5134797780e55258d89062776'}] | {'10.1177_1941738118796130-fig1': ['Because of his worsening clinical status and concern for peritonitis, especially given the negative Carnett sign,3 despite the ecchymosis, he was urgently referred to the emergency room for possible peritonitis. Evaluation revealed a white blood cell count of 11,000 with 85% neutrophils and otherwise normal laboratory test results. A computed tomography scan of the abdomen and pelvis showed pneumoperitoneum with small-volume hemoperitoneum (<xref ref-type="fig" rid="10.1177_1941738118796130-fig1">Figure 1</xref>).).'], '10.1177_1941738118796130-fig2': ['The Carnett sign can assist in differentiating abdominal wall injury from intra-abdominal injury. The Carnett sign is positive when abdominal tenderness to palpation increases or remains the same when the abdominal muscles are activated through an abdominal crunch, indicating injury to the abdominal muscles (<xref ref-type="fig" rid="10.1177_1941738118796130-fig2">Figure 2</xref>).).3 In a study of 24 patients with acute abdomen, 23 with a positive Carnett sign had a normal laparotomy.5 A negative Carnett sign raised our clinical suspicion for intra-abdominal injury, leading to further evaluation.']} | Jejunal Perforation From Blunt Abdominal Trauma by an End Zone Pylon in a Division I Football Player | [
"jejunal perforation",
"football",
"end zone pylon",
"Carnett sign"
] | Sports Health | 1534834800 | To more accurately trigger data acquisition and reduce radiation exposure of coronary computed tomography angiography (CCTA), a multimodal framework utilizing both electrocardiography (ECG) and seismocardiography (SCG) for CCTA prospective gating is presented. Relying upon a three-layer artificial neural network that adaptively fuses individual ECG- and SCG-based quiescence predictions on a beat-by-beat basis, this framework yields a personalized quiescence prediction for each cardiac cycle. This framework was tested on seven healthy subjects (age: 22-48; m/f: 4/3) and eleven cardiac patients (age: 31-78; m/f: 6/5). Seventeen out of 18 benefited from the fusion-based prediction as compared to the ECG-only-based prediction, the traditional prospective gating method. Only one patient whose SCG was compromised by noise was more suitable for ECG-only-based prediction. On average, our fused ECG-SCG-based method improves cardiac quiescence prediction by 47% over ECG-only-based method; with both compared against the gold standard, B-mode echocardiography. Fusion-based prediction is also more resistant to heart rate variability than ECG-only- or SCG-only-based prediction. To assess the clinical value, the diagnostic quality of the CCTA reconstructed volumes from the quiescence derived from ECG-, SCG- and fusion-based predictions were graded by a board-certified radiologist using a Likert response format. Grading results indicated the fusion-based prediction improved diagnostic quality. ECG may be a sub-optimal modality for quiescence prediction and can be enhanced by the multimodal framework. The combination of ECG and SCG signals for quiescence prediction bears promise for a more personalized and reliable approach than ECG-only-based method to predict cardiac quiescence for prospective CCTA gating. | [] | other | PMC6204643 | null | 51 | [
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] | Sports Health. 2018 Aug 21; 10(6):565-566 | NO-CC CODE |
|
68Ga-PSMA-11 PET/CT in primary localized PCa. A 77-year-old man with newly diagnosed high-risk prostate cancer; Gleason 3+3, PSA: 22 ng/mL. He underwent 68Ga-PSMA-11 PET/CT including maximal intensity projection (A), fused coronal, axial PET/CT (B,C), respectively. The images revealed a local focus of uptake in the right peripheral zone of the prostate, with an otherwise negative scan. PSMA, prostate-specific membrane antigen; PSA, prostate-specific antigen; PCa, prostate cancer. | tau-07-05-831-f1 | 7 | 3a829620152c5262c065d2b01265b04371f46e4dd8b9831be1005eb1844267a2 | tau-07-05-831-f1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
791,
1189
] | [{'image_id': 'tau-07-05-831-f8', 'image_file_name': 'tau-07-05-831-f8.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f8.jpg', 'caption': '18F-PSMA-1007 PET/CT of a 72-year-old man with high-risk prostate cancer [Gleason 9 (4+5), Grade Group 5] and rising PSA levels (latest PSA level: 11.2 ng/mL). Coronal maximal intensity projection PET image shows the primary excretion of the tracer by the hepatobiliary system, which may decrease the amount false positive findings from uptake within the ureters and urethra (A). In addition to intraprostatic uptake inguinal (B) and pararectal lymph nodes and one lymph node next to the right distal ureter was shown (C). PSMA, prostate-specific membrane antigen; PSA, prostate-specific antigen.', 'hash': '1ed72e216c3a84c23a67edc5b6bc4cfb23d27a8b2ea48dfaaeeaebbaf3578b6e'}, {'image_id': 'tau-07-05-831-f1', 'image_file_name': 'tau-07-05-831-f1.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f1.jpg', 'caption': '68Ga-PSMA-11 PET/CT in primary localized PCa. A 77-year-old man with newly diagnosed high-risk prostate cancer; Gleason 3+3, PSA: 22 ng/mL. He underwent 68Ga-PSMA-11 PET/CT including maximal intensity projection (A), fused coronal, axial PET/CT (B,C), respectively. The images revealed a local focus of uptake in the right peripheral zone of the prostate, with an otherwise negative scan. PSMA, prostate-specific membrane antigen; PSA, prostate-specific antigen; PCa, prostate cancer.', 'hash': '3a829620152c5262c065d2b01265b04371f46e4dd8b9831be1005eb1844267a2'}, {'image_id': 'tau-07-05-831-f6', 'image_file_name': 'tau-07-05-831-f6.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f6.jpg', 'caption': '18F-DCFPyL in metastatic PCa. A 60-year-old man with history of prostate cancer, Gleason 9 (4+5), status post-prostatectomy, and rising PSA (0.4 ng/mL) 6 years after surgery. 18F-DCFPyL PET imaging including maximal intensity projection (A), axial PET (B,C), axial fused PET/CT (D,E) and axial low dose CT (F,G) show suspicious sub-centimeter right internal iliac and pre-sacral lymph nodes (arrows) at a very low level of PSA. PSA, prostate-specific antigen; PCa, prostate cancer.', 'hash': '640f92be91a29568047fa24cea0874d6b3e819dd04e80800bfbace737b05f2d7'}, {'image_id': 'tau-07-05-831-f7', 'image_file_name': 'tau-07-05-831-f7.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f7.jpg', 'caption': '18F-DCFBC compared to 18F-NaF in metastatic prostate cancer. A 74-year-old man with castrate resistant metastatic prostate cancer and PSA 388.1 ng/mL. 18F-DCFBC (A) detects most bone lesions concordant with 18F-NaF (B) in addition to soft tissue disease. PSA, prostate-specific antigen.', 'hash': '2a9a1321b2294f7389ee407d20a2f17f941e2977902c1ae7e9d7f417cebad323'}, {'image_id': 'tau-07-05-831-f9', 'image_file_name': 'tau-07-05-831-f9.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f9.jpg', 'caption': '18F-PSMA-1007 PET/CT in a man following radiation therapy with biochemical recurrence (PSA 3.7 ng/mL). The study revealed two intraprostatic PSMA-avid foci, without evidence of extraprostatic disease (A,B,C). PSMA, prostate-specific membrane antigen; PSA, prostate-specific antigen.', 'hash': '1e996e8a029610af285cb0970a4e6711b3471dbed3f58df4f7ba5268067816fb'}, {'image_id': 'tau-07-05-831-f3', 'image_file_name': 'tau-07-05-831-f3.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f3.jpg', 'caption': '18F-DCFPyL in primary localized PCa. A 64-year-old man newly diagnosed of high-risk prostate cancer, Gleason 5+4, PSA: 8 ng/mL. 18F-DCFPyL PET maximal intensity projection (A) and axial PET (B) imaging demonstrates a dominant focus in the right apical-mid peripheral zone of the prostate gland with intense 18F-DCFPyL, concordant with a 1.5-cm PIRADS 5 lesion reported on MR-T2W axial imaging (arrows in A,B,C,D) (C). MRI shows two additional PIRADs 4 lesions in the left apical-mid peripheral zone and right anterior transition zone, with moderately intense 18F-DCFPyL uptake (arrowheads in B,C,D). All DCFPyL-avid lesions were concordant with MRI findings as seen on the fused PET-MRI image (D). PCa, prostate cancer; PSA, prostate-specific antigen.', 'hash': '7088ad789fda6ae3acd227ebf55efc5b2b1000b1f01c86ab26f9ab8ab109376c'}, {'image_id': 'tau-07-05-831-f4', 'image_file_name': 'tau-07-05-831-f4.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f4.jpg', 'caption': '18F-DCFBC in biochemical recurrence. A 59-year-old man status post prostatectomy with biochemical recurrence, PSA 2 ng/mL. 18F-DCFBC shows focal uptake in 8-mm mesenteric node (arrows). Left image is maximum intensity projection of 18F-DCFBC PET. Right top image is axial PET/CT fusion of pelvis and right bottom is corresponding axial PET of pelvis. PSA, prostate-specific antigen.', 'hash': '5248ceef626f3ac26b77f635afea4512fcd353fde87108d0d1b5b7065bee09e9'}, {'image_id': 'tau-07-05-831-f5', 'image_file_name': 'tau-07-05-831-f5.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f5.jpg', 'caption': '18F-DCFPyL in metastatic PCa. A 62-year-old man with metastatic castrate-resistant prostate cancer, status post-prostatectomy, salvage radiation, and chemotherapy, with elevated PSA 135 ng/mL and testosterone <20 ng/dL. 18F-DCFPyL PET/CT imaging including maximal intensity projection (A), sagittal PET and fused PET/CT (B,C), and axial PET and fused PET/CT (D,E) show widespread bone metastatic disease and several metastatic liver lesions. PCa, prostate cancer; PSA, prostate-specific antigen.', 'hash': '28eeeebaaa18cf0de4f5ac77a570926b53ceb8f90e9669c1e1e2c70fa681faef'}, {'image_id': 'tau-07-05-831-f2', 'image_file_name': 'tau-07-05-831-f2.jpg', 'image_path': '../data/media_files/PMC6212618/tau-07-05-831-f2.jpg', 'caption': '18F-DCFBC in localized disease. 18F-DCFBC with focal uptake in left apical-mid peripheral zone prostate cancer lesion (blue arrows) but not in benign prostatic hyperplasia (red arrows). Left image is axial PET of prostate and right image is axial T2 MRI.', 'hash': '1c747ac0d21dd43d3169904c2714cbe6e72d58767e3cddc285e4a08a9dbcdc73'}] | {'tau-07-05-831-f1': ['68Ga-PSMA-11 (also known as 68Ga-HBED-CC-PSMA) was introduced in humans in 2012 and is the most widely used and studied PSMA-ligand (5,17,18) (<xref ref-type="fig" rid="tau-07-05-831-f1"><italic>Figure 1</italic></xref>). Figure 1). 68Ga is eluted from a 68Ge/68Ga generator system and added to a binding kit containing the precursor (19). Many centers label the compound on-site because of the relatively short 68-minute half-life of 68Ga (20).'], 'tau-07-05-831-f2': ['Currently, more studies have been published with 18F-DCFBC than 18F-DCFPyL. Turkbey et al. (4), showed that localized PCas were detected by 18F-DCFBC and mpMRI and these lesions were subsequently validated with MRI/transrectal ultrasound guided biopsy or radical prostatectomy. Tumor uptake was noted to be very high with maximum standardized uptake values (SUVmax) greater than 100 in some lesions 1 and 2 h post-injection (50). The method was highly sensitive for intermediate and high-grade primary cancers (4) (<xref ref-type="fig" rid="tau-07-05-831-f2"><italic>Figure 2</italic></xref>). Figure 2). 18F-DCFPyL PET uptake, was contingent on higher Gleason pattern 4 within tumors, whereas lower-grade PCa with Gleason pattern 3 tended to have much lower radiotracer uptake (52) (<xref ref-type="fig" rid="tau-07-05-831-f3"><italic>Figure 3</italic></xref>) (Figure 3) (2).'], 'tau-07-05-831-f4': ['In the BCR setting, Turkbey et al. (4) demonstrated that 18F-DCFBC could detect recurrences (either local or lymph node) in 60.3% of patients without evidence of disease on conventional imaging (<xref ref-type="fig" rid="tau-07-05-831-f4"><italic>Figure 4</italic></xref>). Imaging detection rate correlated to PSA values with a threshold PSA of 0.78 ng/mL or above, highly predictive of a positive scan. Interestingly, focal Figure 4). Imaging detection rate correlated to PSA values with a threshold PSA of 0.78 ng/mL or above, highly predictive of a positive scan. Interestingly, focal 18F-DCFBC results changed clinical management in 51.2% of patients due to the detection of more-than-expected disease. This compelling application for non-invasive detection of recurrent disease by radiolabeled PSMA binding agents is promising in advancing therapeutic strategies. Subsequently, it was shown that the sensitivity of both 18F-DCFPyL (n=62) and 68Ga-PSMA-11 (n=129) was significantly associated with absolute PSA levels (54). In this study, Dietlein et al. showed that for a PSA range of 0.5–3.5 µg/L, the PSA-stratified sensitivity of 18F-DCFPyL significantly exceeded that of 68Ga-PSMA-11 (88% vs. 66%). Outside of this range, sensitivity was comparably low (for PSA <0.5 µg/L) or high (for PSA >3.5 µg/L). After radiotherapy, tracer sensitivity was largely PSA-independent. In a subsample of 25 patients examined with both tracers, the distribution patterns of 18F-DCFPyL and 68Ga-PSMA-11 were comparable, but 18F-DCFPyL scans detected additional lesions in 36% of the patients (54). Since both radiotracers target the same epitope on the PSMA molecule, the improved lesion detection efficiency of 18F-DCFPyL relative to the 68Ga-labelled PSMA agent may reflect the intrinsic advantages of 18F as a PET radionuclide or subtle pharmacokinetic differences. 18F-DCFPyL has the advantages of being cyclotron-based and has a longer half-life and more favorable energy levels, resulting in improved spatial resolution, owing to lower background activity in non-target tissues (54).'], 'tau-07-05-831-f5': ['The fluorinated compounds have also been used in the metastatic setting. 18F-DCFBC outperformed conventional imaging and detected a larger number of lesions in lymph nodes, bone and soft tissue with a sensitivity of 92% compared to 71% for traditional imaging modalities (55). In the metastatic setting, Rowe et al. (56) also showed that 18F-DCFPyL PET/CT outperformed conventional imaging by detecting an overall larger number of positive sites of either local recurrence, lymph nodes, or bones (138 definitive sites and 1 equivocal versus 30 definitive sites with 15 equivocal) (56). Several prospective and multicenter trials are currently under way to better determine the diagnostic performance of 18F-DCFPyL PET for distant sites of PCa (<xref ref-type="fig" rid="tau-07-05-831-f5"><italic>Figures 5,6</italic></xref>Figures 5,6<xref ref-type="fig" rid="tau-07-05-831-f6" />).).'], 'tau-07-05-831-f7': ['Imaging of metastatic bone disease has yielded intriguing findings. In comparison to the highly sensitive but nonspecific 18F-NaF, the detection of metastatic bone lesions by 18F-DCFBC or 18F-DCFPyL depends on the treatment status and disease stage (57) (<xref ref-type="fig" rid="tau-07-05-831-f7"><italic>Figure 7</italic></xref>). In patients on androgen deprivation therapy, Figure 7). In patients on androgen deprivation therapy, 18F-NaF identifies more bone lesions than 18F-DCFBC in the early, castrate sensitive phase but as disease advances to castration resistance, detection rates are similar in both tracers. This is thought to occur due to hormonal suppression of PCa cells leading to senescence and reduced PSMA expression which is reactivated when resistance develops. The secondary effects of bone remodeling appear to persist throughout and are consequently visible with 18F-NaF but not PSMA PET/CT (58). The implication is that PSMA radiotracers may be able to distinguish castration sensitive and castration resistant disease of the bones when combined with a cross sectional bone scan method. This may provide insights into the origins of castration resistance.'], 'tau-07-05-831-f8': ['Recently, a compound based on 68Ga-PSMA-617, which is 18F-labeled has been introduced with a similar diagnostic and therapeutic potential to 68Ga-PSMA-11 or 68Ga-PSMA-I&T (36). PSMA-1007 presents a unique biodistribution compared to the other known PSMA-ligands as excretion follows the hepatobiliary pathway, instead of the more common urinary route (59). This provides several advantages with regard to primary staging and local recurrence, as there is less uptake in the anatomical area of the prostate and surrounding tissue. Also, the radiation dose is comparable to other PSMA-ligands, but due to hepatobiliary excretion there is a slightly different organ dose distribution with a higher dose to the liver parenchyma and lower radiation dose to the urinary bladder (<xref ref-type="fig" rid="tau-07-05-831-f8"><italic>Figure 8</italic></xref>). In preliminary studies, this excretory pathway is beneficial in the visualization of prostate and ureter region as well as pelvis for metastatic lymph nodes (Figure 8). In preliminary studies, this excretory pathway is beneficial in the visualization of prostate and ureter region as well as pelvis for metastatic lymph nodes (59-61), but comparative studies have not been done. When PSMA-1007 was compared to mpMRI for local staging, both modalities exhibited similar accuracy (60). Paddubny et al. presented its use in the setting of BCR and equivocal findings on MRI (<xref ref-type="fig" rid="tau-07-05-831-f9"><italic>Figure 9</italic></xref>). In this study, the Figure 9). In this study, the 18F-PSMA-1007 PET/CT scan allowed identification of local PCa recurrence, which was otherwise not seen on mpMRI (62).']} | Keeping up with the prostate-specific membrane antigens (PSMAs): an introduction to a new class of positron emission tomography (PET) imaging agents | [
"Positron emission tomography/computed tomography (PET/CT)",
"nuclear medicine",
"prostatic neoplasms",
"tomography",
"emission-computed, single-photon",
"gallium"
] | Transl Androl Urol | 1538377200 | Protein-protein interactions (PPIs) are at the core of molecular control over cellular function. Multivalency in PPI formation, such as via proteins with multiple binding sites and different valencies, requires fundamental understanding to address correlated challenges in pathologies and drug development. Thermodynamic binding models are needed to provide frameworks for describing multivalent PPIs. We established a model based on ditopic host-guest systems featuring the effective molarity, a hallmark property of multivalency, as a prime parameter governing the intramolecular binding in divalent interactions. By way of illustration, we study the interaction of the bivalent 14-3-3 protein scaffold with both the nonavalent CFTR and the hexavalent LRRK2 proteins, determining the underlying thermodynamics and providing insights into the role of individual sites in the context of the multivalent platform. Fitting of binding data reveals enthalpy-entropy correlation in both systems. Simulations of speciations for the entire phosphorylated protein domains reveal that the CFTR protein preferably binds to 14-3-3 by combinations including the strongest binding site pS768, but that other binding sites take over when this site is eliminated, leading to only a minor decrease in total affinity for 14-3-3. For LRRK2, two binding sites dominate the complex formation with 14-3-3, but the distantly located pS1444 site also plays a role in complex formation. Thermodynamic modeling of these multivalent PPIs allowed analyzing and predicting the effects of individual sites regarding their modulation via, for example, (de)phosphorylation or small-molecule targeting. The results specifically bring forward the potential of PPI stabilization, as an entry for drug discovery for multivalent PPIs. | [
"14-3-3 Proteins",
"Models, Molecular",
"Point Mutation",
"Protein Binding",
"Thermodynamics"
] | other | PMC6212618 | null | 53 | [
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] | Transl Androl Urol. 2018 Oct; 7(5):831-843 | NO-CC CODE |
|
Contrast enhanced abdomen/pelvic MRI—new enlarged and necrotic lymph nodes. A 68-year-old man had gross hematuria for a month, and was found on cystoscopy to have high-grade urothelial bladder carcinoma. Axial post-contrast T1 fat saturation image (A) reveals an enlarged enhancing left retrocrural lymph node (arrow). Coronal post-contrast T1 fat saturation image (B) reveals additional enlarged and heterogeneously enhancing periaortic and right external iliac lymph nodes (arrows). Axial T1 fat saturation post-contrast (C) and axial T2 fat saturation (D) images reveal a peripherally enhancing (C, arrow) and a centrally T2-hyperintense (D, arrow) necrotic left common iliac lymph node. | tau-07-05-804-f9 | 7 | 2b050f8d05723d53b8c0c6e14f17de720c4ed84fdba61e7a52ab77a8e4b7ff18 | tau-07-05-804-f9.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
700,
136
] | [{'image_id': 'tau-07-05-804-f8', 'image_file_name': 'tau-07-05-804-f8.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f8.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—positive right obturator lymph node. A 73-year-old woman presented with urinary retention and pelvic pressure. Cystoscopy and subsequent biopsy revealed high-grade T2 bladder carcinoma with urethral involvement. T2-weighted MR of the pelvis without fat saturation (A) shows a 7 mm right obturator lymph node (arrows) which enhances heterogeneously following gadolinium administration on T1 fat saturation post-contrast images (B). Although not enlarged, the lobulated margins and interval development since a CT performed 3 weeks previously make this highly suspicious for malignancy. Surgical pathology following cystectomy and lymph node dissection confirmed multiple positive right pelvic lymph nodes.', 'hash': 'b820b94cbe0817cce929644195587e12bea709bad00b0fc4a18cf532c6e58e83'}, {'image_id': 'tau-07-05-804-f1', 'image_file_name': 'tau-07-05-804-f1.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f1.jpg', 'caption': 'Schematic of bladder cancer lymph node staging (15). Nodal staging of bladder cancer detailed for N1–M1a (A-D). N1 disease depicted as a single abnormal left perivesical lymph node (A). N2 disease depicted as multiple abnormal left regional lymph nodes (B). N3 disease depicted as abnormal lymph nodes involving the left common iliac distribution (C). M1a disease depicted as abnormal lymph nodes involving the para-aortic region above the level of the aortic bifurcation (D). Abnormal lymph nodes are depicted with irregular margins for illustrative purposes.', 'hash': '373e1da7edce73d7b62b9273828689ef430a55d1dd214b28dc11aef7fbd32762'}, {'image_id': 'tau-07-05-804-f6', 'image_file_name': 'tau-07-05-804-f6.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f6.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—new right aortocaval lymph node. A 67-year-old man was initially diagnosed with T1 bladder cancer and treated with mitomycin and BCG. One year later, new round lymph nodes were found on surveillance MR. A mildly enlarged round aortocaval lymph node (arrows) is isointense to the spleen on T2-weighted imaging (A), without a discernable fatty hilum and shows heterogeneous enhancement following intravenous gadolinium-contrast administration on T1 fat saturation post-contrast images (B). BCG, Bacillus Calmette-Guerin.', 'hash': 'ed623d6f5960403df1860712487bf64622678685dbbc5a42dbb17a6fde563f86'}, {'image_id': 'tau-07-05-804-f7', 'image_file_name': 'tau-07-05-804-f7.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f7.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—positive right external iliac lymph node. A 71-year-old woman presented with gross hematuria, leading to a TURBT which showed T2NxMx papillary urothelial carcinoma. Unfortunately, the patient progressed on neoadjuvant chemotherapy. A pelvic MR showed a 3 cm right external iliac lymph node (white arrows) which is hypointense on coronal T2-weighted images (A) and peripherally-enhancing on axial post-contrast T1-weighted imaging with fat saturation (B). The primary bladder mass (asterisk) and post-obstructive left hydroureter (black arrow) are present on the coronal T2-weighted image (A). TURBT, transurethral resection of bladder tumor.', 'hash': '69f378e175c103097c039923e81b4dd617da7b7652e0ca88c291745b912521ab'}, {'image_id': 'tau-07-05-804-f9', 'image_file_name': 'tau-07-05-804-f9.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f9.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—new enlarged and necrotic lymph nodes. A 68-year-old man had gross hematuria for a month, and was found on cystoscopy to have high-grade urothelial bladder carcinoma. Axial post-contrast T1 fat saturation image (A) reveals an enlarged enhancing left retrocrural lymph node (arrow). Coronal post-contrast T1 fat saturation image (B) reveals additional enlarged and heterogeneously enhancing periaortic and right external iliac lymph nodes (arrows). Axial T1 fat saturation post-contrast (C) and axial T2 fat saturation (D) images reveal a peripherally enhancing (C, arrow) and a centrally T2-hyperintense (D, arrow) necrotic left common iliac lymph node.', 'hash': '2b050f8d05723d53b8c0c6e14f17de720c4ed84fdba61e7a52ab77a8e4b7ff18'}, {'image_id': 'tau-07-05-804-f10', 'image_file_name': 'tau-07-05-804-f10.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f10.jpg', 'caption': '18F-FDG PET/CT—FDG-avid, morphologically benign appearing lymph nodes. A 73-year-old woman presented with hematuria and was found to have invasive high-grade papillary urothelial carcinoma on cystoscopy. One year following cystectomy and local lymph node dissection, a PET-CT was performed and demonstrated foci of increased radiotracer uptake at multiple locations including the left periaortic (A, black arrow) and left common iliac (C) stations, corresponding to morphologically normal lymph nodes on the associated non-contrast CT (B,D; white arrows). Percutaneous biopsy confirmed sites of metastatic urothelial carcinoma.', 'hash': 'c47cea21c67afb5802270fc9f0e48e700c58e56e8042fe1db8b1bc1585b5eb17'}, {'image_id': 'tau-07-05-804-f3', 'image_file_name': 'tau-07-05-804-f3.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f3.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—false negative right external iliac lymph node. A 59-year-old man presented with left groin and flank pain, without hematuria, and was found to have an invasive (T3) bladder urothelial mass obstructing the right ureter. A staging CT showed no evidence of metastatic disease, with the largest visible lymph node in the right external iliac station measuring just 5 mm short axis (arrow). However, radical cystoprostatectomy with pelvic lymph node dissection performed less than one month later yielded multiple bilateral pelvic lymph nodes positive for malignancy.', 'hash': '211ed4b3a40c544f695465e9bed01cc43b57b0ffd9d6cddb36d39e5f19bcfde1'}, {'image_id': 'tau-07-05-804-f4', 'image_file_name': 'tau-07-05-804-f4.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f4.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive left common iliac lymph node. A 67-year-old man was initially diagnosed with T1 bladder cancer and treated with mitomycin and BCG. One year later, he developed a recurrent bladder mass. A follow-up CT at that time revealed an abnormal left common iliac lymph node (black arrows) seen in axial (A) and coronal (B) planes on contrast-enhanced CT. This was excised and positive for urothelial metastasis on pathology. The primary bladder mass is visible on the coronal image (B, white arrow). BCG, Bacillus Calmette-Guerin.', 'hash': '9713dcc27bbac469887a95cde441ab55e0f704a8783ac8ce6a34b168809f2c41'}, {'image_id': 'tau-07-05-804-f5', 'image_file_name': 'tau-07-05-804-f5.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f5.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive right external iliac lymph node. A 65-year-old man presented with gross hematuria and was found to have T1 disease on TURBT, treated initially with BCG. Follow-up imaging revealed multiple enlarged lymph nodes: including a right external iliac lymph node (arrows) seen on post-contrast CT in axial (A) and coronal (B) planes. The patient underwent radical cystoprostatectomy and was histologically staged as T4 N2 Mx. TURBT, transurethral resection of bladder tumor; BCG, Bacillus Calmette-Guerin.', 'hash': '45e5fb3aa9bcd08c51022770288977aba7dcbf8ed47b8dab9f2ee90ec3aee6f0'}, {'image_id': 'tau-07-05-804-f2', 'image_file_name': 'tau-07-05-804-f2.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f2.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive perivesical lymph node. A 68-year-old man with known invasive urothelial bladder cancer (asterisk) presents for staging. Contrast enhanced CT images reveal a round non-enlarged right perivesical lymph node suspicious for metastatic involvement (arrow). The patient underwent radical cystoprostatectomy, pelvic lymph node dissection, and ileal loop urinary diversion, with pathology confirming involvement of the perivesical node and final histologic stage of T3b N1 M0 bladder cancer.', 'hash': 'eb38e0f829f19a66bb20ec2b3ea499633ff453472378c98452231128223ea83a'}, {'image_id': 'tau-07-05-804-f11', 'image_file_name': 'tau-07-05-804-f11.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f11.jpg', 'caption': '18F-FDG PET/CT—FDG-avid positive right inguinal lymph node. A 71-year-old male presented with rectal pain, leading to a colonoscopy which showed a large pelvic mass. He then developed a rectovesical fistula and was found to have high-grade urothelial cancer with sarcomatoid differentiation, treated with pelvic exenteration. The subsequent FDG PET-CT shows a metabolically active (A, black arrow), enlarged right inguinal lymph node (B, white arrow) which was percutaneously biopsied and which was confirmed as a urothelial cancer lymph node metastasis.', 'hash': 'e7e052c16c8f4fe12eb55826644436f2d5a69b548e00d5c7360502696c067fcd'}] | {'tau-07-05-804-f1': ['Staging of nodal metastases from bladder cancer is based on the current TNM guidelines from the American Joint Committee on Cancer, eight edition staging manual (AJCC 8th edition) (8,14,15). Definitive lymph node staging is based on post-operative histology and should only be suggested on imaging studies when lymph node involvement is obvious. Nodal staging, which is provided in <xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>Figure 1, is also summarized as follows:', 'N1 disease is defined as bladder cancer involvement of one regional pelvic lymph node. Regional lymph nodes include: inguinal, hypogastric (internal iliac chain), obturator, external iliac chain, perivesical, and presacral lymph nodes, all of which are located below the level of the common iliac arteries (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14-16);', 'N2 disease is defined as involvement of more than one regional lymph node. It should be noted that in previous staging classification systems, differences in involved lymph node size were also used to differentiate N1 from N2 disease; however, lymph node size is no longer considered part of the staging system (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,15).', 'N3 disease is defined as a positive lymph node along either or both of the common iliac chains (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14,15);', 'Importantly, involved lymph nodes, above the level of the aortic bifurcation, are now considered to be distant metastases and classified as M1a disease. Metastases to other organs are now classified as M1b disease) (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14,15).'], 'tau-07-05-804-f2': ['While the use of lymph node size alone (measured in maximal short axis diameter) had historically been a marker of nodal involvement and was used as a measure of nodal staging in prior iterations of the AJCC TNM criteria (5), size criteria alone, as a marker of disease involvement is imprecise due to the wide range of normal lymph node sizes and the potential for metastatic bladder cancer occurring within non-enlarged lymph nodes (<xref ref-type="fig" rid="tau-07-05-804-f2"><italic>Figures 2,3</italic></xref>Figures 2,3<xref ref-type="fig" rid="tau-07-05-804-f3" />) () (12). Acknowledging these limitations, recommended size thresholds that have been utilized are ≥8 mm in short axis for suspected abnormal pelvic lymph nodes and ≥10 mm in short axis for abdominal lymph nodes (<xref ref-type="fig" rid="tau-07-05-804-f4"><italic>Figure 4</italic></xref>) (Figure 4) (12).', 'For the previously provided reasons, some investigators have found that identification of suspected metastatic lymph nodes on CT is most accurate when lymph node features, in addition to size, are assessed. This includes lymph node shape and internal architecture/attenuation (12). Normal lymph nodes generally have a reniform shape, as they frequently contain a central fatty hilum. The loss of this normal appearance and a more rounded (<xref ref-type="fig" rid="tau-07-05-804-f2"><italic>Figure 2</italic></xref>) or irregular configuration should be concerning for involvement with metastatic tumor (Figure 2) or irregular configuration should be concerning for involvement with metastatic tumor (<xref ref-type="fig" rid="tau-07-05-804-f5"><italic>Figure 5</italic></xref>) (Figure 5) (12,20). Another alteration of internal nodal architecture, is central low attenuation due to necrosis, which should be considered suspicious for metastatic disease when a primary pelvic neoplasm is present (21).'], 'tau-07-05-804-f6': ['Compared with CT, the use of multiple pulse sequences in MRI allows for evaluation of a large number additional lymph node features independent of size, potentially aiding in the identification or exclusion of metastatic disease (7). Some of the many other multiparametric MRI lymph node features that can be evaluated include: lymph node shape, T1 and T2 signal intensity, diffusion characteristics, and the temporal nature of gadolinium-based contrast material enhancement. On MRI, normal lymph nodes often demonstrate a reniform configuration with a preserved central T1-hyperintense fatty hilum (<xref ref-type="fig" rid="tau-07-05-804-f6"><italic>Figure 6</italic></xref>). Metastatic lymph nodes are more likely to demonstrate heterogeneous and/or increased peripheral enhancement (Figure 6). Metastatic lymph nodes are more likely to demonstrate heterogeneous and/or increased peripheral enhancement (<xref ref-type="fig" rid="tau-07-05-804-f7"><italic>Figures 7,8</italic></xref>Figures 7,8<xref ref-type="fig" rid="tau-07-05-804-f8" />) and heterogeneous central T1-hypointensity and T2-hyperintensity, corresponding to necrosis () and heterogeneous central T1-hypointensity and T2-hyperintensity, corresponding to necrosis (<xref ref-type="fig" rid="tau-07-05-804-f9"><italic>Figure 9</italic></xref>) (Figure 9) (21). To date, no routinely acquired MRI sequence (T1-weighted, T2-weighted, diffusion weighted or gadolinium-enhanced) has been shown to be superior to the others in terms of increasing sensitivity or specificity in the detection of metastatic lymph nodes (7,13,26).'], 'tau-07-05-804-f10': ['Metastatic lymph nodes have increased metabolic activity and, therefore, demonstrate increased radiotracer uptake on PET/CT (<xref ref-type="fig" rid="tau-07-05-804-f10"><italic>Figures 10,11</italic></xref>Figures 10,11<xref ref-type="fig" rid="tau-07-05-804-f11" />) () (4). Unfortunately, due to limitations in spatial resolution of PET, PET/CT has decreased accuracy in the detection of disease in non-enlarged but metastatic lymph nodes (<5 mm) (12). Furthermore, increased radiotracer uptake can be seen in lymph nodes that do not harbor metastatic disease (i.e., reactive or inflammatory lymph nodes). Thus, there are many opportunities for both false negative and false positive PET/CT results in bladder cancer patients.']} | A pictorial review of bladder cancer nodal metastases | [
"Bladder cancer",
"lymph node metastasis",
"nodal metastasis",
"nodal staging",
"urothelial cancer"
] | Transl Androl Urol | 1538377200 | Endometrial cancer is the most common gynecological cancer in the United States. We wanted to identify epigenetic aberrations involving microRNAs (miRNAs), whose genes become hypermethylated in endometrial primary tumors. By integrating known miRNA sequences from the miRNA database (miRBase) with DNA methylation data from methyl-CpG-capture sequencing, we identified 111 differentially methylated regions (DMRs) associated with CpG islands (CGIs) and miRNAs. Among them, 22 DMRs related to 29 miRNAs and within 8 kb of CGIs were hypermethylated in endometrial tumors but not in normal endometrium. miR-137 was further validated in additional endometrial primary tumors. Hypermethylation of miR-137 was found in both endometrioid and serous endometrial cancer (P < 0.01), and it led to the loss of miR-137 expression. Treating hypermethylated endometrial cancer cells with epigenetic inhibitors reactivated miR-137. Moreover, genetic overexpression of miR-137 suppressed cancer cell proliferation and colony formation in vitro. When transfected cancer cells were implanted into nude mice, the cells that overexpressed miR-137 grew more slowly and formed smaller tumors (P < 0.05) than vector transfectants. Histologically, xenograft tumors from cancer cells expressing miR-137 were less proliferative (P < 0.05), partly due to inhibition of EZH2 and LSD1 expression (P < 0.01) in both the transfected cancer cells and tumors. Reporter assays indicated that miR-137 targets EZH2 and LSD1. These results suggest that miR-137 is a tumor suppressor that is repressed in endometrial cancer because the promoter of its gene becomes hypermethylated. | [
"Adenocarcinoma",
"Animals",
"Cell Line, Tumor",
"DNA Methylation",
"Endometrial Neoplasms",
"Enhancer of Zeste Homolog 2 Protein",
"Female",
"Gene Silencing",
"Histone Demethylases",
"Humans",
"Mice, Nude",
"MicroRNAs"
] | other | PMC6212631 | null | 43 | [
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] | Transl Androl Urol. 2018 Oct; 7(5):804-813 | NO-CC CODE |
|
18F-FDG PET/CT—FDG-avid, morphologically benign appearing lymph nodes. A 73-year-old woman presented with hematuria and was found to have invasive high-grade papillary urothelial carcinoma on cystoscopy. One year following cystectomy and local lymph node dissection, a PET-CT was performed and demonstrated foci of increased radiotracer uptake at multiple locations including the left periaortic (A, black arrow) and left common iliac (C) stations, corresponding to morphologically normal lymph nodes on the associated non-contrast CT (B,D; white arrows). Percutaneous biopsy confirmed sites of metastatic urothelial carcinoma. | tau-07-05-804-f10 | 7 | c47cea21c67afb5802270fc9f0e48e700c58e56e8042fe1db8b1bc1585b5eb17 | tau-07-05-804-f10.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
700,
122
] | [{'image_id': 'tau-07-05-804-f8', 'image_file_name': 'tau-07-05-804-f8.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f8.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—positive right obturator lymph node. A 73-year-old woman presented with urinary retention and pelvic pressure. Cystoscopy and subsequent biopsy revealed high-grade T2 bladder carcinoma with urethral involvement. T2-weighted MR of the pelvis without fat saturation (A) shows a 7 mm right obturator lymph node (arrows) which enhances heterogeneously following gadolinium administration on T1 fat saturation post-contrast images (B). Although not enlarged, the lobulated margins and interval development since a CT performed 3 weeks previously make this highly suspicious for malignancy. Surgical pathology following cystectomy and lymph node dissection confirmed multiple positive right pelvic lymph nodes.', 'hash': 'b820b94cbe0817cce929644195587e12bea709bad00b0fc4a18cf532c6e58e83'}, {'image_id': 'tau-07-05-804-f1', 'image_file_name': 'tau-07-05-804-f1.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f1.jpg', 'caption': 'Schematic of bladder cancer lymph node staging (15). Nodal staging of bladder cancer detailed for N1–M1a (A-D). N1 disease depicted as a single abnormal left perivesical lymph node (A). N2 disease depicted as multiple abnormal left regional lymph nodes (B). N3 disease depicted as abnormal lymph nodes involving the left common iliac distribution (C). M1a disease depicted as abnormal lymph nodes involving the para-aortic region above the level of the aortic bifurcation (D). Abnormal lymph nodes are depicted with irregular margins for illustrative purposes.', 'hash': '373e1da7edce73d7b62b9273828689ef430a55d1dd214b28dc11aef7fbd32762'}, {'image_id': 'tau-07-05-804-f6', 'image_file_name': 'tau-07-05-804-f6.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f6.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—new right aortocaval lymph node. A 67-year-old man was initially diagnosed with T1 bladder cancer and treated with mitomycin and BCG. One year later, new round lymph nodes were found on surveillance MR. A mildly enlarged round aortocaval lymph node (arrows) is isointense to the spleen on T2-weighted imaging (A), without a discernable fatty hilum and shows heterogeneous enhancement following intravenous gadolinium-contrast administration on T1 fat saturation post-contrast images (B). BCG, Bacillus Calmette-Guerin.', 'hash': 'ed623d6f5960403df1860712487bf64622678685dbbc5a42dbb17a6fde563f86'}, {'image_id': 'tau-07-05-804-f7', 'image_file_name': 'tau-07-05-804-f7.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f7.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—positive right external iliac lymph node. A 71-year-old woman presented with gross hematuria, leading to a TURBT which showed T2NxMx papillary urothelial carcinoma. Unfortunately, the patient progressed on neoadjuvant chemotherapy. A pelvic MR showed a 3 cm right external iliac lymph node (white arrows) which is hypointense on coronal T2-weighted images (A) and peripherally-enhancing on axial post-contrast T1-weighted imaging with fat saturation (B). The primary bladder mass (asterisk) and post-obstructive left hydroureter (black arrow) are present on the coronal T2-weighted image (A). TURBT, transurethral resection of bladder tumor.', 'hash': '69f378e175c103097c039923e81b4dd617da7b7652e0ca88c291745b912521ab'}, {'image_id': 'tau-07-05-804-f9', 'image_file_name': 'tau-07-05-804-f9.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f9.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—new enlarged and necrotic lymph nodes. A 68-year-old man had gross hematuria for a month, and was found on cystoscopy to have high-grade urothelial bladder carcinoma. Axial post-contrast T1 fat saturation image (A) reveals an enlarged enhancing left retrocrural lymph node (arrow). Coronal post-contrast T1 fat saturation image (B) reveals additional enlarged and heterogeneously enhancing periaortic and right external iliac lymph nodes (arrows). Axial T1 fat saturation post-contrast (C) and axial T2 fat saturation (D) images reveal a peripherally enhancing (C, arrow) and a centrally T2-hyperintense (D, arrow) necrotic left common iliac lymph node.', 'hash': '2b050f8d05723d53b8c0c6e14f17de720c4ed84fdba61e7a52ab77a8e4b7ff18'}, {'image_id': 'tau-07-05-804-f10', 'image_file_name': 'tau-07-05-804-f10.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f10.jpg', 'caption': '18F-FDG PET/CT—FDG-avid, morphologically benign appearing lymph nodes. A 73-year-old woman presented with hematuria and was found to have invasive high-grade papillary urothelial carcinoma on cystoscopy. One year following cystectomy and local lymph node dissection, a PET-CT was performed and demonstrated foci of increased radiotracer uptake at multiple locations including the left periaortic (A, black arrow) and left common iliac (C) stations, corresponding to morphologically normal lymph nodes on the associated non-contrast CT (B,D; white arrows). Percutaneous biopsy confirmed sites of metastatic urothelial carcinoma.', 'hash': 'c47cea21c67afb5802270fc9f0e48e700c58e56e8042fe1db8b1bc1585b5eb17'}, {'image_id': 'tau-07-05-804-f3', 'image_file_name': 'tau-07-05-804-f3.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f3.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—false negative right external iliac lymph node. A 59-year-old man presented with left groin and flank pain, without hematuria, and was found to have an invasive (T3) bladder urothelial mass obstructing the right ureter. A staging CT showed no evidence of metastatic disease, with the largest visible lymph node in the right external iliac station measuring just 5 mm short axis (arrow). However, radical cystoprostatectomy with pelvic lymph node dissection performed less than one month later yielded multiple bilateral pelvic lymph nodes positive for malignancy.', 'hash': '211ed4b3a40c544f695465e9bed01cc43b57b0ffd9d6cddb36d39e5f19bcfde1'}, {'image_id': 'tau-07-05-804-f4', 'image_file_name': 'tau-07-05-804-f4.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f4.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive left common iliac lymph node. A 67-year-old man was initially diagnosed with T1 bladder cancer and treated with mitomycin and BCG. One year later, he developed a recurrent bladder mass. A follow-up CT at that time revealed an abnormal left common iliac lymph node (black arrows) seen in axial (A) and coronal (B) planes on contrast-enhanced CT. This was excised and positive for urothelial metastasis on pathology. The primary bladder mass is visible on the coronal image (B, white arrow). BCG, Bacillus Calmette-Guerin.', 'hash': '9713dcc27bbac469887a95cde441ab55e0f704a8783ac8ce6a34b168809f2c41'}, {'image_id': 'tau-07-05-804-f5', 'image_file_name': 'tau-07-05-804-f5.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f5.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive right external iliac lymph node. A 65-year-old man presented with gross hematuria and was found to have T1 disease on TURBT, treated initially with BCG. Follow-up imaging revealed multiple enlarged lymph nodes: including a right external iliac lymph node (arrows) seen on post-contrast CT in axial (A) and coronal (B) planes. The patient underwent radical cystoprostatectomy and was histologically staged as T4 N2 Mx. TURBT, transurethral resection of bladder tumor; BCG, Bacillus Calmette-Guerin.', 'hash': '45e5fb3aa9bcd08c51022770288977aba7dcbf8ed47b8dab9f2ee90ec3aee6f0'}, {'image_id': 'tau-07-05-804-f2', 'image_file_name': 'tau-07-05-804-f2.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f2.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive perivesical lymph node. A 68-year-old man with known invasive urothelial bladder cancer (asterisk) presents for staging. Contrast enhanced CT images reveal a round non-enlarged right perivesical lymph node suspicious for metastatic involvement (arrow). The patient underwent radical cystoprostatectomy, pelvic lymph node dissection, and ileal loop urinary diversion, with pathology confirming involvement of the perivesical node and final histologic stage of T3b N1 M0 bladder cancer.', 'hash': 'eb38e0f829f19a66bb20ec2b3ea499633ff453472378c98452231128223ea83a'}, {'image_id': 'tau-07-05-804-f11', 'image_file_name': 'tau-07-05-804-f11.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f11.jpg', 'caption': '18F-FDG PET/CT—FDG-avid positive right inguinal lymph node. A 71-year-old male presented with rectal pain, leading to a colonoscopy which showed a large pelvic mass. He then developed a rectovesical fistula and was found to have high-grade urothelial cancer with sarcomatoid differentiation, treated with pelvic exenteration. The subsequent FDG PET-CT shows a metabolically active (A, black arrow), enlarged right inguinal lymph node (B, white arrow) which was percutaneously biopsied and which was confirmed as a urothelial cancer lymph node metastasis.', 'hash': 'e7e052c16c8f4fe12eb55826644436f2d5a69b548e00d5c7360502696c067fcd'}] | {'tau-07-05-804-f1': ['Staging of nodal metastases from bladder cancer is based on the current TNM guidelines from the American Joint Committee on Cancer, eight edition staging manual (AJCC 8th edition) (8,14,15). Definitive lymph node staging is based on post-operative histology and should only be suggested on imaging studies when lymph node involvement is obvious. Nodal staging, which is provided in <xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>Figure 1, is also summarized as follows:', 'N1 disease is defined as bladder cancer involvement of one regional pelvic lymph node. Regional lymph nodes include: inguinal, hypogastric (internal iliac chain), obturator, external iliac chain, perivesical, and presacral lymph nodes, all of which are located below the level of the common iliac arteries (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14-16);', 'N2 disease is defined as involvement of more than one regional lymph node. It should be noted that in previous staging classification systems, differences in involved lymph node size were also used to differentiate N1 from N2 disease; however, lymph node size is no longer considered part of the staging system (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,15).', 'N3 disease is defined as a positive lymph node along either or both of the common iliac chains (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14,15);', 'Importantly, involved lymph nodes, above the level of the aortic bifurcation, are now considered to be distant metastases and classified as M1a disease. Metastases to other organs are now classified as M1b disease) (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14,15).'], 'tau-07-05-804-f2': ['While the use of lymph node size alone (measured in maximal short axis diameter) had historically been a marker of nodal involvement and was used as a measure of nodal staging in prior iterations of the AJCC TNM criteria (5), size criteria alone, as a marker of disease involvement is imprecise due to the wide range of normal lymph node sizes and the potential for metastatic bladder cancer occurring within non-enlarged lymph nodes (<xref ref-type="fig" rid="tau-07-05-804-f2"><italic>Figures 2,3</italic></xref>Figures 2,3<xref ref-type="fig" rid="tau-07-05-804-f3" />) () (12). Acknowledging these limitations, recommended size thresholds that have been utilized are ≥8 mm in short axis for suspected abnormal pelvic lymph nodes and ≥10 mm in short axis for abdominal lymph nodes (<xref ref-type="fig" rid="tau-07-05-804-f4"><italic>Figure 4</italic></xref>) (Figure 4) (12).', 'For the previously provided reasons, some investigators have found that identification of suspected metastatic lymph nodes on CT is most accurate when lymph node features, in addition to size, are assessed. This includes lymph node shape and internal architecture/attenuation (12). Normal lymph nodes generally have a reniform shape, as they frequently contain a central fatty hilum. The loss of this normal appearance and a more rounded (<xref ref-type="fig" rid="tau-07-05-804-f2"><italic>Figure 2</italic></xref>) or irregular configuration should be concerning for involvement with metastatic tumor (Figure 2) or irregular configuration should be concerning for involvement with metastatic tumor (<xref ref-type="fig" rid="tau-07-05-804-f5"><italic>Figure 5</italic></xref>) (Figure 5) (12,20). Another alteration of internal nodal architecture, is central low attenuation due to necrosis, which should be considered suspicious for metastatic disease when a primary pelvic neoplasm is present (21).'], 'tau-07-05-804-f6': ['Compared with CT, the use of multiple pulse sequences in MRI allows for evaluation of a large number additional lymph node features independent of size, potentially aiding in the identification or exclusion of metastatic disease (7). Some of the many other multiparametric MRI lymph node features that can be evaluated include: lymph node shape, T1 and T2 signal intensity, diffusion characteristics, and the temporal nature of gadolinium-based contrast material enhancement. On MRI, normal lymph nodes often demonstrate a reniform configuration with a preserved central T1-hyperintense fatty hilum (<xref ref-type="fig" rid="tau-07-05-804-f6"><italic>Figure 6</italic></xref>). Metastatic lymph nodes are more likely to demonstrate heterogeneous and/or increased peripheral enhancement (Figure 6). Metastatic lymph nodes are more likely to demonstrate heterogeneous and/or increased peripheral enhancement (<xref ref-type="fig" rid="tau-07-05-804-f7"><italic>Figures 7,8</italic></xref>Figures 7,8<xref ref-type="fig" rid="tau-07-05-804-f8" />) and heterogeneous central T1-hypointensity and T2-hyperintensity, corresponding to necrosis () and heterogeneous central T1-hypointensity and T2-hyperintensity, corresponding to necrosis (<xref ref-type="fig" rid="tau-07-05-804-f9"><italic>Figure 9</italic></xref>) (Figure 9) (21). To date, no routinely acquired MRI sequence (T1-weighted, T2-weighted, diffusion weighted or gadolinium-enhanced) has been shown to be superior to the others in terms of increasing sensitivity or specificity in the detection of metastatic lymph nodes (7,13,26).'], 'tau-07-05-804-f10': ['Metastatic lymph nodes have increased metabolic activity and, therefore, demonstrate increased radiotracer uptake on PET/CT (<xref ref-type="fig" rid="tau-07-05-804-f10"><italic>Figures 10,11</italic></xref>Figures 10,11<xref ref-type="fig" rid="tau-07-05-804-f11" />) () (4). Unfortunately, due to limitations in spatial resolution of PET, PET/CT has decreased accuracy in the detection of disease in non-enlarged but metastatic lymph nodes (<5 mm) (12). Furthermore, increased radiotracer uptake can be seen in lymph nodes that do not harbor metastatic disease (i.e., reactive or inflammatory lymph nodes). Thus, there are many opportunities for both false negative and false positive PET/CT results in bladder cancer patients.']} | A pictorial review of bladder cancer nodal metastases | [
"Bladder cancer",
"lymph node metastasis",
"nodal metastasis",
"nodal staging",
"urothelial cancer"
] | Transl Androl Urol | 1538377200 | Endometrial cancer is the most common gynecological cancer in the United States. We wanted to identify epigenetic aberrations involving microRNAs (miRNAs), whose genes become hypermethylated in endometrial primary tumors. By integrating known miRNA sequences from the miRNA database (miRBase) with DNA methylation data from methyl-CpG-capture sequencing, we identified 111 differentially methylated regions (DMRs) associated with CpG islands (CGIs) and miRNAs. Among them, 22 DMRs related to 29 miRNAs and within 8 kb of CGIs were hypermethylated in endometrial tumors but not in normal endometrium. miR-137 was further validated in additional endometrial primary tumors. Hypermethylation of miR-137 was found in both endometrioid and serous endometrial cancer (P < 0.01), and it led to the loss of miR-137 expression. Treating hypermethylated endometrial cancer cells with epigenetic inhibitors reactivated miR-137. Moreover, genetic overexpression of miR-137 suppressed cancer cell proliferation and colony formation in vitro. When transfected cancer cells were implanted into nude mice, the cells that overexpressed miR-137 grew more slowly and formed smaller tumors (P < 0.05) than vector transfectants. Histologically, xenograft tumors from cancer cells expressing miR-137 were less proliferative (P < 0.05), partly due to inhibition of EZH2 and LSD1 expression (P < 0.01) in both the transfected cancer cells and tumors. Reporter assays indicated that miR-137 targets EZH2 and LSD1. These results suggest that miR-137 is a tumor suppressor that is repressed in endometrial cancer because the promoter of its gene becomes hypermethylated. | [
"Adenocarcinoma",
"Animals",
"Cell Line, Tumor",
"DNA Methylation",
"Endometrial Neoplasms",
"Enhancer of Zeste Homolog 2 Protein",
"Female",
"Gene Silencing",
"Histone Demethylases",
"Humans",
"Mice, Nude",
"MicroRNAs"
] | other | PMC6212631 | null | 43 | [
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] | Transl Androl Urol. 2018 Oct; 7(5):804-813 | NO-CC CODE |
|
Contrast enhanced CT abdomen/pelvis—positive right external iliac lymph node. A 65-year-old man presented with gross hematuria and was found to have T1 disease on TURBT, treated initially with BCG. Follow-up imaging revealed multiple enlarged lymph nodes: including a right external iliac lymph node (arrows) seen on post-contrast CT in axial (A) and coronal (B) planes. The patient underwent radical cystoprostatectomy and was histologically staged as T4 N2 Mx. TURBT, transurethral resection of bladder tumor; BCG, Bacillus Calmette-Guerin. | tau-07-05-804-f5 | 7 | 45e5fb3aa9bcd08c51022770288977aba7dcbf8ed47b8dab9f2ee90ec3aee6f0 | tau-07-05-804-f5.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
767,
338
] | [{'image_id': 'tau-07-05-804-f8', 'image_file_name': 'tau-07-05-804-f8.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f8.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—positive right obturator lymph node. A 73-year-old woman presented with urinary retention and pelvic pressure. Cystoscopy and subsequent biopsy revealed high-grade T2 bladder carcinoma with urethral involvement. T2-weighted MR of the pelvis without fat saturation (A) shows a 7 mm right obturator lymph node (arrows) which enhances heterogeneously following gadolinium administration on T1 fat saturation post-contrast images (B). Although not enlarged, the lobulated margins and interval development since a CT performed 3 weeks previously make this highly suspicious for malignancy. Surgical pathology following cystectomy and lymph node dissection confirmed multiple positive right pelvic lymph nodes.', 'hash': 'b820b94cbe0817cce929644195587e12bea709bad00b0fc4a18cf532c6e58e83'}, {'image_id': 'tau-07-05-804-f1', 'image_file_name': 'tau-07-05-804-f1.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f1.jpg', 'caption': 'Schematic of bladder cancer lymph node staging (15). Nodal staging of bladder cancer detailed for N1–M1a (A-D). N1 disease depicted as a single abnormal left perivesical lymph node (A). N2 disease depicted as multiple abnormal left regional lymph nodes (B). N3 disease depicted as abnormal lymph nodes involving the left common iliac distribution (C). M1a disease depicted as abnormal lymph nodes involving the para-aortic region above the level of the aortic bifurcation (D). Abnormal lymph nodes are depicted with irregular margins for illustrative purposes.', 'hash': '373e1da7edce73d7b62b9273828689ef430a55d1dd214b28dc11aef7fbd32762'}, {'image_id': 'tau-07-05-804-f6', 'image_file_name': 'tau-07-05-804-f6.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f6.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—new right aortocaval lymph node. A 67-year-old man was initially diagnosed with T1 bladder cancer and treated with mitomycin and BCG. One year later, new round lymph nodes were found on surveillance MR. A mildly enlarged round aortocaval lymph node (arrows) is isointense to the spleen on T2-weighted imaging (A), without a discernable fatty hilum and shows heterogeneous enhancement following intravenous gadolinium-contrast administration on T1 fat saturation post-contrast images (B). BCG, Bacillus Calmette-Guerin.', 'hash': 'ed623d6f5960403df1860712487bf64622678685dbbc5a42dbb17a6fde563f86'}, {'image_id': 'tau-07-05-804-f7', 'image_file_name': 'tau-07-05-804-f7.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f7.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—positive right external iliac lymph node. A 71-year-old woman presented with gross hematuria, leading to a TURBT which showed T2NxMx papillary urothelial carcinoma. Unfortunately, the patient progressed on neoadjuvant chemotherapy. A pelvic MR showed a 3 cm right external iliac lymph node (white arrows) which is hypointense on coronal T2-weighted images (A) and peripherally-enhancing on axial post-contrast T1-weighted imaging with fat saturation (B). The primary bladder mass (asterisk) and post-obstructive left hydroureter (black arrow) are present on the coronal T2-weighted image (A). TURBT, transurethral resection of bladder tumor.', 'hash': '69f378e175c103097c039923e81b4dd617da7b7652e0ca88c291745b912521ab'}, {'image_id': 'tau-07-05-804-f9', 'image_file_name': 'tau-07-05-804-f9.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f9.jpg', 'caption': 'Contrast enhanced abdomen/pelvic MRI—new enlarged and necrotic lymph nodes. A 68-year-old man had gross hematuria for a month, and was found on cystoscopy to have high-grade urothelial bladder carcinoma. Axial post-contrast T1 fat saturation image (A) reveals an enlarged enhancing left retrocrural lymph node (arrow). Coronal post-contrast T1 fat saturation image (B) reveals additional enlarged and heterogeneously enhancing periaortic and right external iliac lymph nodes (arrows). Axial T1 fat saturation post-contrast (C) and axial T2 fat saturation (D) images reveal a peripherally enhancing (C, arrow) and a centrally T2-hyperintense (D, arrow) necrotic left common iliac lymph node.', 'hash': '2b050f8d05723d53b8c0c6e14f17de720c4ed84fdba61e7a52ab77a8e4b7ff18'}, {'image_id': 'tau-07-05-804-f10', 'image_file_name': 'tau-07-05-804-f10.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f10.jpg', 'caption': '18F-FDG PET/CT—FDG-avid, morphologically benign appearing lymph nodes. A 73-year-old woman presented with hematuria and was found to have invasive high-grade papillary urothelial carcinoma on cystoscopy. One year following cystectomy and local lymph node dissection, a PET-CT was performed and demonstrated foci of increased radiotracer uptake at multiple locations including the left periaortic (A, black arrow) and left common iliac (C) stations, corresponding to morphologically normal lymph nodes on the associated non-contrast CT (B,D; white arrows). Percutaneous biopsy confirmed sites of metastatic urothelial carcinoma.', 'hash': 'c47cea21c67afb5802270fc9f0e48e700c58e56e8042fe1db8b1bc1585b5eb17'}, {'image_id': 'tau-07-05-804-f3', 'image_file_name': 'tau-07-05-804-f3.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f3.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—false negative right external iliac lymph node. A 59-year-old man presented with left groin and flank pain, without hematuria, and was found to have an invasive (T3) bladder urothelial mass obstructing the right ureter. A staging CT showed no evidence of metastatic disease, with the largest visible lymph node in the right external iliac station measuring just 5 mm short axis (arrow). However, radical cystoprostatectomy with pelvic lymph node dissection performed less than one month later yielded multiple bilateral pelvic lymph nodes positive for malignancy.', 'hash': '211ed4b3a40c544f695465e9bed01cc43b57b0ffd9d6cddb36d39e5f19bcfde1'}, {'image_id': 'tau-07-05-804-f4', 'image_file_name': 'tau-07-05-804-f4.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f4.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive left common iliac lymph node. A 67-year-old man was initially diagnosed with T1 bladder cancer and treated with mitomycin and BCG. One year later, he developed a recurrent bladder mass. A follow-up CT at that time revealed an abnormal left common iliac lymph node (black arrows) seen in axial (A) and coronal (B) planes on contrast-enhanced CT. This was excised and positive for urothelial metastasis on pathology. The primary bladder mass is visible on the coronal image (B, white arrow). BCG, Bacillus Calmette-Guerin.', 'hash': '9713dcc27bbac469887a95cde441ab55e0f704a8783ac8ce6a34b168809f2c41'}, {'image_id': 'tau-07-05-804-f5', 'image_file_name': 'tau-07-05-804-f5.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f5.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive right external iliac lymph node. A 65-year-old man presented with gross hematuria and was found to have T1 disease on TURBT, treated initially with BCG. Follow-up imaging revealed multiple enlarged lymph nodes: including a right external iliac lymph node (arrows) seen on post-contrast CT in axial (A) and coronal (B) planes. The patient underwent radical cystoprostatectomy and was histologically staged as T4 N2 Mx. TURBT, transurethral resection of bladder tumor; BCG, Bacillus Calmette-Guerin.', 'hash': '45e5fb3aa9bcd08c51022770288977aba7dcbf8ed47b8dab9f2ee90ec3aee6f0'}, {'image_id': 'tau-07-05-804-f2', 'image_file_name': 'tau-07-05-804-f2.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f2.jpg', 'caption': 'Contrast enhanced CT abdomen/pelvis—positive perivesical lymph node. A 68-year-old man with known invasive urothelial bladder cancer (asterisk) presents for staging. Contrast enhanced CT images reveal a round non-enlarged right perivesical lymph node suspicious for metastatic involvement (arrow). The patient underwent radical cystoprostatectomy, pelvic lymph node dissection, and ileal loop urinary diversion, with pathology confirming involvement of the perivesical node and final histologic stage of T3b N1 M0 bladder cancer.', 'hash': 'eb38e0f829f19a66bb20ec2b3ea499633ff453472378c98452231128223ea83a'}, {'image_id': 'tau-07-05-804-f11', 'image_file_name': 'tau-07-05-804-f11.jpg', 'image_path': '../data/media_files/PMC6212631/tau-07-05-804-f11.jpg', 'caption': '18F-FDG PET/CT—FDG-avid positive right inguinal lymph node. A 71-year-old male presented with rectal pain, leading to a colonoscopy which showed a large pelvic mass. He then developed a rectovesical fistula and was found to have high-grade urothelial cancer with sarcomatoid differentiation, treated with pelvic exenteration. The subsequent FDG PET-CT shows a metabolically active (A, black arrow), enlarged right inguinal lymph node (B, white arrow) which was percutaneously biopsied and which was confirmed as a urothelial cancer lymph node metastasis.', 'hash': 'e7e052c16c8f4fe12eb55826644436f2d5a69b548e00d5c7360502696c067fcd'}] | {'tau-07-05-804-f1': ['Staging of nodal metastases from bladder cancer is based on the current TNM guidelines from the American Joint Committee on Cancer, eight edition staging manual (AJCC 8th edition) (8,14,15). Definitive lymph node staging is based on post-operative histology and should only be suggested on imaging studies when lymph node involvement is obvious. Nodal staging, which is provided in <xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>Figure 1, is also summarized as follows:', 'N1 disease is defined as bladder cancer involvement of one regional pelvic lymph node. Regional lymph nodes include: inguinal, hypogastric (internal iliac chain), obturator, external iliac chain, perivesical, and presacral lymph nodes, all of which are located below the level of the common iliac arteries (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14-16);', 'N2 disease is defined as involvement of more than one regional lymph node. It should be noted that in previous staging classification systems, differences in involved lymph node size were also used to differentiate N1 from N2 disease; however, lymph node size is no longer considered part of the staging system (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,15).', 'N3 disease is defined as a positive lymph node along either or both of the common iliac chains (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14,15);', 'Importantly, involved lymph nodes, above the level of the aortic bifurcation, are now considered to be distant metastases and classified as M1a disease. Metastases to other organs are now classified as M1b disease) (<xref ref-type="fig" rid="tau-07-05-804-f1"><italic>Figure 1</italic></xref>) (Figure 1) (8,14,15).'], 'tau-07-05-804-f2': ['While the use of lymph node size alone (measured in maximal short axis diameter) had historically been a marker of nodal involvement and was used as a measure of nodal staging in prior iterations of the AJCC TNM criteria (5), size criteria alone, as a marker of disease involvement is imprecise due to the wide range of normal lymph node sizes and the potential for metastatic bladder cancer occurring within non-enlarged lymph nodes (<xref ref-type="fig" rid="tau-07-05-804-f2"><italic>Figures 2,3</italic></xref>Figures 2,3<xref ref-type="fig" rid="tau-07-05-804-f3" />) () (12). Acknowledging these limitations, recommended size thresholds that have been utilized are ≥8 mm in short axis for suspected abnormal pelvic lymph nodes and ≥10 mm in short axis for abdominal lymph nodes (<xref ref-type="fig" rid="tau-07-05-804-f4"><italic>Figure 4</italic></xref>) (Figure 4) (12).', 'For the previously provided reasons, some investigators have found that identification of suspected metastatic lymph nodes on CT is most accurate when lymph node features, in addition to size, are assessed. This includes lymph node shape and internal architecture/attenuation (12). Normal lymph nodes generally have a reniform shape, as they frequently contain a central fatty hilum. The loss of this normal appearance and a more rounded (<xref ref-type="fig" rid="tau-07-05-804-f2"><italic>Figure 2</italic></xref>) or irregular configuration should be concerning for involvement with metastatic tumor (Figure 2) or irregular configuration should be concerning for involvement with metastatic tumor (<xref ref-type="fig" rid="tau-07-05-804-f5"><italic>Figure 5</italic></xref>) (Figure 5) (12,20). Another alteration of internal nodal architecture, is central low attenuation due to necrosis, which should be considered suspicious for metastatic disease when a primary pelvic neoplasm is present (21).'], 'tau-07-05-804-f6': ['Compared with CT, the use of multiple pulse sequences in MRI allows for evaluation of a large number additional lymph node features independent of size, potentially aiding in the identification or exclusion of metastatic disease (7). Some of the many other multiparametric MRI lymph node features that can be evaluated include: lymph node shape, T1 and T2 signal intensity, diffusion characteristics, and the temporal nature of gadolinium-based contrast material enhancement. On MRI, normal lymph nodes often demonstrate a reniform configuration with a preserved central T1-hyperintense fatty hilum (<xref ref-type="fig" rid="tau-07-05-804-f6"><italic>Figure 6</italic></xref>). Metastatic lymph nodes are more likely to demonstrate heterogeneous and/or increased peripheral enhancement (Figure 6). Metastatic lymph nodes are more likely to demonstrate heterogeneous and/or increased peripheral enhancement (<xref ref-type="fig" rid="tau-07-05-804-f7"><italic>Figures 7,8</italic></xref>Figures 7,8<xref ref-type="fig" rid="tau-07-05-804-f8" />) and heterogeneous central T1-hypointensity and T2-hyperintensity, corresponding to necrosis () and heterogeneous central T1-hypointensity and T2-hyperintensity, corresponding to necrosis (<xref ref-type="fig" rid="tau-07-05-804-f9"><italic>Figure 9</italic></xref>) (Figure 9) (21). To date, no routinely acquired MRI sequence (T1-weighted, T2-weighted, diffusion weighted or gadolinium-enhanced) has been shown to be superior to the others in terms of increasing sensitivity or specificity in the detection of metastatic lymph nodes (7,13,26).'], 'tau-07-05-804-f10': ['Metastatic lymph nodes have increased metabolic activity and, therefore, demonstrate increased radiotracer uptake on PET/CT (<xref ref-type="fig" rid="tau-07-05-804-f10"><italic>Figures 10,11</italic></xref>Figures 10,11<xref ref-type="fig" rid="tau-07-05-804-f11" />) () (4). Unfortunately, due to limitations in spatial resolution of PET, PET/CT has decreased accuracy in the detection of disease in non-enlarged but metastatic lymph nodes (<5 mm) (12). Furthermore, increased radiotracer uptake can be seen in lymph nodes that do not harbor metastatic disease (i.e., reactive or inflammatory lymph nodes). Thus, there are many opportunities for both false negative and false positive PET/CT results in bladder cancer patients.']} | A pictorial review of bladder cancer nodal metastases | [
"Bladder cancer",
"lymph node metastasis",
"nodal metastasis",
"nodal staging",
"urothelial cancer"
] | Transl Androl Urol | 1538377200 | Endometrial cancer is the most common gynecological cancer in the United States. We wanted to identify epigenetic aberrations involving microRNAs (miRNAs), whose genes become hypermethylated in endometrial primary tumors. By integrating known miRNA sequences from the miRNA database (miRBase) with DNA methylation data from methyl-CpG-capture sequencing, we identified 111 differentially methylated regions (DMRs) associated with CpG islands (CGIs) and miRNAs. Among them, 22 DMRs related to 29 miRNAs and within 8 kb of CGIs were hypermethylated in endometrial tumors but not in normal endometrium. miR-137 was further validated in additional endometrial primary tumors. Hypermethylation of miR-137 was found in both endometrioid and serous endometrial cancer (P < 0.01), and it led to the loss of miR-137 expression. Treating hypermethylated endometrial cancer cells with epigenetic inhibitors reactivated miR-137. Moreover, genetic overexpression of miR-137 suppressed cancer cell proliferation and colony formation in vitro. When transfected cancer cells were implanted into nude mice, the cells that overexpressed miR-137 grew more slowly and formed smaller tumors (P < 0.05) than vector transfectants. Histologically, xenograft tumors from cancer cells expressing miR-137 were less proliferative (P < 0.05), partly due to inhibition of EZH2 and LSD1 expression (P < 0.01) in both the transfected cancer cells and tumors. Reporter assays indicated that miR-137 targets EZH2 and LSD1. These results suggest that miR-137 is a tumor suppressor that is repressed in endometrial cancer because the promoter of its gene becomes hypermethylated. | [
"Adenocarcinoma",
"Animals",
"Cell Line, Tumor",
"DNA Methylation",
"Endometrial Neoplasms",
"Enhancer of Zeste Homolog 2 Protein",
"Female",
"Gene Silencing",
"Histone Demethylases",
"Humans",
"Mice, Nude",
"MicroRNAs"
] | other | PMC6212631 | null | 43 | [
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] | Transl Androl Urol. 2018 Oct; 7(5):804-813 | NO-CC CODE |
|
Serial follow-up of the sagittal view of the aorta. (A) On two days after the birth. (B) On day 20 of his life after pulmonary artery banding surgery. (C) On day 136 of his life after the biventricular repair surgery. | kjtcv-49-107f1 | 7 | 45bebbed7c251f812d8cc055e241cf4f83a25bca0cee369424cf19ccee797a85 | kjtcv-49-107f1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
761,
320
] | [{'image_id': 'kjtcv-49-107f3', 'image_file_name': 'kjtcv-49-107f3.jpg', 'image_path': '../data/media_files/PMC4825911/kjtcv-49-107f3.jpg', 'caption': 'Serial follow-up of the axial view of the heart. (A) On two days after the birth, diffuse thinning of LV wall is found. (B) On day 20 of his life after pulmonary artery banding surgery, increased LV wall thickness and enlarged right cardiac chambers are seen. (C) On day 136 of his life after the biventricular repair surgery, increased LV size and interval decrease in right cardiac chambers are found. LV, left ventricular.', 'hash': '5925aa045e38f084e4eb806946f4a95be8bb340808fe784d0ef2f578acdcc8d9'}, {'image_id': 'kjtcv-49-107f2', 'image_file_name': 'kjtcv-49-107f2.jpg', 'image_path': '../data/media_files/PMC4825911/kjtcv-49-107f2.jpg', 'caption': 'Trend of LAP until 48 hours after PAB. LAP, left atrial pressure; PAB, pulmonary artery banding.', 'hash': 'cd97223a4a826820414b915150d0ed24e4d77443b7c399e367591d620a1f83a6'}, {'image_id': 'kjtcv-49-107f1', 'image_file_name': 'kjtcv-49-107f1.jpg', 'image_path': '../data/media_files/PMC4825911/kjtcv-49-107f1.jpg', 'caption': 'Serial follow-up of the sagittal view of the aorta. (A) On two days after the birth. (B) On day 20 of his life after pulmonary artery banding surgery. (C) On day 136 of his life after the biventricular repair surgery.', 'hash': '45bebbed7c251f812d8cc055e241cf4f83a25bca0cee369424cf19ccee797a85'}] | {'kjtcv-49-107f1': ['A male neonate weighing 3.63 kg was delivered at Asan Medical Center after 39 weeks of uneventful gestation. He was prenatally diagnosed with hypoplastic left heart syndrome (HLHS) and/or coarctation of the aorta (CoA) by a fetal echocardiogram. Upon delivery, his vital signs were stable with oxygen saturation of 90% in the right arm and 88% in the right leg. Initial postnatal echocardiogram revealed mitral stenosis, aortic stenosis, bicuspid aortic valve (AV), patent ductus arteriosus (PDA) with a bidirectional shunt, intact atrial septum, and near normal left ventricle (LV) function with an ejection fraction (EF) of 68%. The mitral valve (MV) and the AV annulus diameters were 7.1 mm (Z-score= −3.47) and 4.2 mm (Z-score= −4.86), respectively. Prostaglandin E was infused immediately (0.008 mcg/kg/min). However, on day 3 of hospitalization, the patient’s vital signs became unstable, including severe fluctuation of blood pressure, increasing blood lactate level, diminishing urine output, and differential cyanosis up to 30% when blood pressure was elevated. Echocardiographic and computed tomography (CT) findings at that time showed right to left dominant PDA flow, retrograde aortic arch flow, and severely decreased left ventricular function with an EF of 36% (Table 1). Volume-measured heart CT produced the following measurements: subaortic area 4 mm; ascending aorta 5 mm; proximal aortic arch 3 mm; distal aortic arch 3.7 mm; and aortic isthmus 4.6 mm. The LV EF was 32.5%, the LV end-diastolic volume (EDV) was 35 mL/m2, and the LV end-systolic volume (ESV) was 24 mL/m2 (Table 1). The patient also had a hypoplastic aortic arch and CoA was not definite (<xref rid="kjtcv-49-107f1" ref-type="fig">Fig. 1</xref>). The patient underwent emergent bilateral pulmonary artery banding using a 3.5-mm Gore-Tex graft as a rescue procedure. Immediately after the surgery, the mean left atrial pressure (LAP) decreased from 33 to 24 mmHg and the systolic blood pressure increased from 64 to 76 mmHg. Six hours after the surgery, the LAP had decreased to 13 mmHg and became almost normal 12 hours later (). The patient underwent emergent bilateral pulmonary artery banding using a 3.5-mm Gore-Tex graft as a rescue procedure. Immediately after the surgery, the mean left atrial pressure (LAP) decreased from 33 to 24 mmHg and the systolic blood pressure increased from 64 to 76 mmHg. Six hours after the surgery, the LAP had decreased to 13 mmHg and became almost normal 12 hours later (<xref rid="kjtcv-49-107f2" ref-type="fig">Fig. 2</xref>) owing to reduction of pulmonary blood flow and LV volume unloading. On postnatal day 15, follow-up echocardiogram due to gradual development of differential cyanosis revealed diminished PDA size from 8 to 3 mm in addition to distinct CoA () owing to reduction of pulmonary blood flow and LV volume unloading. On postnatal day 15, follow-up echocardiogram due to gradual development of differential cyanosis revealed diminished PDA size from 8 to 3 mm in addition to distinct CoA (Table 1). The LV EF was 84.4%, and the MV annulus and AV annulus diameters were 6.8 mm (Z-score= −4.00) and 5.0 mm (Z-score= −3.50), respectively. To determine the LV volume and function, heart CT was performed on postnatal day 20, which showed that the LV EDV changed from 35 to 29 mL/m2 and the LV ESV from 24 to 10 mL/m2, with increased LV wall thickness and improved wall motion (Table 1, <xref rid="kjtcv-49-107f3" ref-type="fig">Fig. 3</xref>). On postnatal day 21, the patient underwent biventricular (BV) repair including pulmonary artery debanding, extensive aortic arch augmentation with main pulmonary artery (MPA) patch and end-to-end anastomosis, MPA and right pulmonary artery angioplasty using glutaraldehyde-fixed pericardium, and creation of an atrial septal defect (ASD, 3.5 mm). ASD creation was performed in order to better support the systemic flow while preventing the left heart from excessive overload and failure [). On postnatal day 21, the patient underwent biventricular (BV) repair including pulmonary artery debanding, extensive aortic arch augmentation with main pulmonary artery (MPA) patch and end-to-end anastomosis, MPA and right pulmonary artery angioplasty using glutaraldehyde-fixed pericardium, and creation of an atrial septal defect (ASD, 3.5 mm). ASD creation was performed in order to better support the systemic flow while preventing the left heart from excessive overload and failure [1]. All procedures were performed under beating heart, and selective cerebral perfusion was instituted by prosthesis-aided cannulation of the right brachiocephalic trunk with moderate hypothermia at 28°C to 30°C. The cardiopulmonary bypass time and selective cere-bro-myocardial perfusion time were 141 and 36 minutes, respectively. To avoid compression by the sternum, the patient was transferred to the intensive care unit with an open sternum and delayed sternal closure was performed the next day. During this period, his vital signs and LAP were within a normal range. The patient was extubated on postoperative day 5 and was discharged on postoperative day 13 without complications. A postoperative follow-up echocardiogram demonstrated normal ventricular function, no mitral or aortic stenosis, no residual stenosis at the arch repair site, and iatrogenic ASD (3 mm). The diameters of the MV and AV annulus had increased to 8.6 mm (Z-score= −2.41) and 5.9 mm (Z-score= −1.85), respectively (Table 1). The patient was clinically well seven months following his surgery and with similar echocardiographic and CT findings (Table 1, <xref rid="kjtcv-49-107f1" ref-type="fig">Fig. 1</xref>).).']} | Biventricular Repair after Bilateral Pulmonary Artery Banding as a Rescue Procedure for a Neonate with Hypoplastic Left Heart Complex | [
"Congenital heart disease",
"Hypoplastic Left Heart Syndrome",
"Pulmonary artery",
"Biventricular repair"
] | Korean J Thorac Cardiovasc Surg | 1459839600 | The rupture of an internal mammary artery (IMA) aneurysm in a patient with type 1 neurofibromatosis (NF-1) is a rare but life-threatening complication requiring emergency management. A 50-year-old man with NF-1 was transferred to the emergency department of Kyungpook National University Hospital, where an IMA aneurysmal rupture and hemothorax were diagnosed and drained. The IMA aneurysmal rupture and hemothorax were successfully repaired by staged management combining endovascular treatment and subsequent video-assisted thoracoscopic surgery (VATS). The patient required cardiopulmonary cerebral resuscitation, the staged management of coil embolization, and a subsequent VATS procedure. This staged approach may be an effective therapeutic strategy in cases of IMA aneurysmal rupture. | [] | other | PMC4825911 | null | 8 | [
"{'Citation': 'Riccardi VM. Von Recklinghausen neurofibromatosis. N Engl J Med. 1981;305:1617–27. doi: 10.1056/NEJM198112313052704.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1056/NEJM198112313052704'}, {'@IdType': 'pubmed', '#text': '6796886'}]}}",
"{'Citation': 'Hongsakul K, Rookkapan S, Tanutit P, Pakdeejit S, Songjamrat A, Sungsiri J. Spontaneous massive hemothorax in a patient with neurofibromatosis type 1 with successful transarterial embolization. Korean J Radiol. 2013;14:86–90. doi: 10.3348/kjr.2013.14.1.86.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.3348/kjr.2013.14.1.86'}, {'@IdType': 'pmc', '#text': 'PMC3542307'}, {'@IdType': 'pubmed', '#text': '23323035'}]}}",
"{'Citation': 'Chang WC, Hsu HH, Chang H, Chen CY. Spontaneous hemothorax caused by a ruptured intercostal artery aneurysm in von Recklinghausen’s neurofibromatosis. J Formos Med Assoc. 2005;104:286–9.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15909069'}}}",
"{'Citation': 'Rodriguez-Guzman M, Gallegos-Carrera B, Vicente-Antunes S, Fernandez-Ormaechea I, Zapatero-Gaviria J, Villar-Alvarez F. Spontaneous hemothorax in a patient with von Recklinghausen’s disease. J Clin Med Res. 2014;6:149–52.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3935525'}, {'@IdType': 'pubmed', '#text': '24578758'}]}}",
"{'Citation': 'Kim SJ, Kim CW, Kim S, et al. Endovascular treatment of a ruptured internal thoracic artery pseudoaneurysm presenting as a massive hemothorax in a patient with type I neurofibromatosis. Cardiovasc Intervent Radiol. 2005;28:818–21. doi: 10.1007/s00270-004-0067-8.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1007/s00270-004-0067-8'}, {'@IdType': 'pubmed', '#text': '16059758'}]}}",
"{'Citation': 'Vaziri M, Mehrazma M. Massive spontaneous hemothorax associated with Von Recklinghausen’s disease. Ann Thorac Surg. 2006;82:1500–1. doi: 10.1016/j.athoracsur.2006.02.010.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1016/j.athoracsur.2006.02.010'}, {'@IdType': 'pubmed', '#text': '16996963'}]}}",
"{'Citation': 'Fukuda W, Taniguchi S, Fukuda I., Md Phd Endovascular treatment of ruptured intercostal arteriovenous fistulas associated with neurofibromatosis type 1. Ann Vasc Dis. 2012;5:109–12. doi: 10.3400/avd.cr.11.00078.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.3400/avd.cr.11.00078'}, {'@IdType': 'pmc', '#text': 'PMC3595905'}, {'@IdType': 'pubmed', '#text': '23555499'}]}}",
"{'Citation': 'Miura H, Taira O, Uchida O, Usuda J, Hirai S, Kato H. Spontaneous haemothorax associated with von Recklinghausen’s disease: review of occurrence in Japan. Thorax. 1997;52:577–8. doi: 10.1136/thx.52.6.577.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1136/thx.52.6.577'}, {'@IdType': 'pmc', '#text': 'PMC1758578'}, {'@IdType': 'pubmed', '#text': '9227730'}]}}"
] | Korean J Thorac Cardiovasc Surg. 2016 Apr 5; 49(2):107-111 | NO-CC CODE |
|
On a computed tomography angiogram at the 12-year follow-up. (A) Straight flow of left ventricular outflow tract and (B) straight flow of right ventricular outflow tract and stenosis of main pulmonary artery are observed. | kjtcv-49-112f1 | 7 | b943c5a0c8a23754ea2de103bf9e314419f99ad84e9d3552a0a092e8644049b0 | kjtcv-49-112f1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
714,
361
] | [{'image_id': 'kjtcv-49-112f1', 'image_file_name': 'kjtcv-49-112f1.jpg', 'image_path': '../data/media_files/PMC4825912/kjtcv-49-112f1.jpg', 'caption': 'On a computed tomography angiogram at the 12-year follow-up. (A) Straight flow of left ventricular outflow tract and (B) straight flow of right ventricular outflow tract and stenosis of main pulmonary artery are observed.', 'hash': 'b943c5a0c8a23754ea2de103bf9e314419f99ad84e9d3552a0a092e8644049b0'}] | {'kjtcv-49-112f1': ['At the 12-year postoperative follow-up, the patient was free of symptoms. Echocardiography showed normal left ventricular systolic function and a widely patent LVOT without turbulence. Computed tomographic angiography showed a straightforward LVOT and RVOT (<xref rid="kjtcv-49-112f1" ref-type="fig">Fig. 1</xref>). Mild AR was observed as before; the annulus of the ascending aorta measured 17 mm (Z-value=0.19) and the mean flow velocity of the ascending aorta was 1.2 m/sec. The annulus of the pulmonary artery measured 16 mm (Z-value= −2.0). However, the peak velocities of the MPA and PA branches remained low (2.6 m/sec and 2.6–3.5 m/sec, respectively) due to the stenosis of the MPA (9 mm, Z-value= −5.36) and PA branches (right, 9.4 mm; Z-value= −2.09; left, 11 mm; Z-value= −0.24). Pulmonary regurgitation (PR) was not observed.). Mild AR was observed as before; the annulus of the ascending aorta measured 17 mm (Z-value=0.19) and the mean flow velocity of the ascending aorta was 1.2 m/sec. The annulus of the pulmonary artery measured 16 mm (Z-value= −2.0). However, the peak velocities of the MPA and PA branches remained low (2.6 m/sec and 2.6–3.5 m/sec, respectively) due to the stenosis of the MPA (9 mm, Z-value= −5.36) and PA branches (right, 9.4 mm; Z-value= −2.09; left, 11 mm; Z-value= −0.24). Pulmonary regurgitation (PR) was not observed.']} | Long-Term Follow-Up of the Half-Turned Truncal Switch Operation for Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis | [
"Congenital heart disease, arterial switch",
"Transposition of great vessels",
"Heart septal defects, ventricular",
"Pulmonary valve stenosis",
"Half-turned truncal switch operation"
] | Korean J Thorac Cardiovasc Surg | 1459839600 | A mass excision surrounding the bronchial stump was performed to exclude malignancy in a 42-year-old man who had undergone a right lower lobectomy for lung cancer. The mass was identified as a cicatricial fibroma. Cicatricial fibromatosis, which is desmoid fibromatosis that arises in a surgical scar, is a well-known clinical condition. It consists of histologically benign neoplasms. Their occurrence after thoracic surgery is extremely rare. Biopsy or excision of suspicious lesions is very important for diagnosis. R0 resection remains the principal outcome for intra-thoracic desmoid fibromatosis. We report that a cicatricial fibromatosis in the subcarinal space was removed after suspicion of local recurrence at the bronchial stump follwing lobectomy for lung cancer. | [] | other | PMC4825912 | null | 5 | [
"{'Citation': 'Matrai Z, Toth L, Szentirmay Z, Papp J, Langmar Z, Kasler M. Multidisciplinary treatment of intra-thoracic desmoid tumors: case series and narrative review. Med Sci Monit. 2012;18:CS17–25. doi: 10.12659/MSM.882506.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.12659/MSM.882506'}, {'@IdType': 'pmc', '#text': 'PMC3560762'}, {'@IdType': 'pubmed', '#text': '22367132'}]}}",
"{'Citation': 'Bolke E, Krasniqi H, Lammering G, et al. Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature. Eur J Med Res. 2009;14:240–3. doi: 10.1186/2047-783X-14-6-240.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1186/2047-783X-14-6-240'}, {'@IdType': 'pmc', '#text': 'PMC3352015'}, {'@IdType': 'pubmed', '#text': '19541583'}]}}",
"{'Citation': 'Mackenzie DH. The fibromatoses: a clinicopathological concept. Br Med J. 1972;4:277–81. doi: 10.1136/bmj.4.5835.277.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1136/bmj.4.5835.277'}, {'@IdType': 'pmc', '#text': 'PMC1788842'}, {'@IdType': 'pubmed', '#text': '4563457'}]}}",
"{'Citation': 'Mori T, Yamada T, Ohba Y, et al. A case of desmoid-type fibromatosis arising after thoracotomy for lung cancer with a review of the english and Japanese literature. Ann Thorac Cardiovasc Surg. 2014;20( Suppl):465–9. doi: 10.5761/atcs.cr.12.02149.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.5761/atcs.cr.12.02149'}, {'@IdType': 'pubmed', '#text': '23558226'}]}}",
"{'Citation': 'Hansmann A, Adolph C, Vogel T, Unger A, Moeslein G. High-dose tamoxifen and sulindac as first-line treatment for desmoid tumors. Cancer. 2004;100:612–20. doi: 10.1002/cncr.11937.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'doi', '#text': '10.1002/cncr.11937'}, {'@IdType': 'pubmed', '#text': '14745880'}]}}"
] | Korean J Thorac Cardiovasc Surg. 2016 Apr 5; 49(2):112-114 | NO-CC CODE |
|
(A) T2-weighted image, frontal plane. (B) T1-weighted + CM image, frontal plane. Cavity in the apex of the left lung. | poljradiol-77-3-25-g003 | 7 | f8b7f609049ccd4a3f35d67d34246d0830e54b904489c7bc1ea2a682ea118bf4 | poljradiol-77-3-25-g003.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
720,
355
] | [{'image_id': 'poljradiol-77-3-25-g012', 'image_file_name': 'poljradiol-77-3-25-g012.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g012.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T2-weighted image, transverse plane. Th7–Th9 spondylodiscitis, high signal intensity of the bone marrow of Th7 and Th9 vertebral bodies and high signal of intervertebral discs, high signal – liquefactive necrosis – of subtotally destructed Th8 vertebral body – spinal cord compression.', 'hash': 'bec03301650da7545df8934b48bdbe9e82292b9c4907169f2969fe1e8d392c70'}, {'image_id': 'poljradiol-77-3-25-g004', 'image_file_name': 'poljradiol-77-3-25-g004.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g004.jpg', 'caption': '(A) T2-weighted image, transverse plane. (B) T1-weighted + CM image, transverse plane. Right pyothorax. Contrast enhancement of paravertebral pathological mass.', 'hash': '271069e7ac2ad23fe2dcd3299a9c9ca53480a7be9055a5acf575bfb8e21853b2'}, {'image_id': 'poljradiol-77-3-25-g003', 'image_file_name': 'poljradiol-77-3-25-g003.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g003.jpg', 'caption': '(A) T2-weighted image, frontal plane. (B) T1-weighted + CM image, frontal plane. Cavity in the apex of the left lung.', 'hash': 'f8b7f609049ccd4a3f35d67d34246d0830e54b904489c7bc1ea2a682ea118bf4'}, {'image_id': 'poljradiol-77-3-25-g013', 'image_file_name': 'poljradiol-77-3-25-g013.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g013.jpg', 'caption': 'Follow-up CT after surgery. MPR reconstruction.', 'hash': '1c92505e64cea4970fe4576039df64b4e88dc4967518cd39c563fb8638653588'}, {'image_id': 'poljradiol-77-3-25-g002', 'image_file_name': 'poljradiol-77-3-25-g002.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g002.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. Contrast enhancement of paravertebral and epidural intra-canal spinal pathological mass.', 'hash': '0493ee11e5e6fd053cb2d95add5425b56a01bb5bccaf9993477f3504e34152e2'}, {'image_id': 'poljradiol-77-3-25-g005', 'image_file_name': 'poljradiol-77-3-25-g005.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g005.jpg', 'caption': 'CT + CM. (A) transverse plane. (B) MPR reconstruction. Left pyothorax.', 'hash': '66c91bf53ccb5c921c966774ad28157f805e29d43dda5f5ddb853850895e27ce'}, {'image_id': 'poljradiol-77-3-25-g006', 'image_file_name': 'poljradiol-77-3-25-g006.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g006.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. (C) T1-weighted + CM image, frontal plane. Contrast enhancement of paravertebral and epidural intra-canal pathological mass. Bilateral pyothorax.', 'hash': '52899467ba638bc7ea62236efbcd16e97b4952ffd2cd8b49a8cc8087ba876fba'}, {'image_id': 'poljradiol-77-3-25-g001', 'image_file_name': 'poljradiol-77-3-25-g001.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g001.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T2-weighted image, transverse plane. C5–C7 spondylodiscitis, high signal intensity of the bone marrow of vertebral bodies and high signal intensity of intervertebral discs with destruction of C6 vertebral body, spinal cord compression.', 'hash': 'cc1ced72b197a6d97fd6959c122f6b25e9cf0abee6728c4689ee4877736bac1e'}, {'image_id': 'poljradiol-77-3-25-g008', 'image_file_name': 'poljradiol-77-3-25-g008.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g008.jpg', 'caption': 'T1-weighted + CM image, sagittal plane. Contrast enhancement of paravertebral pathological mass. Epidural empyema in the cervical and thoracic part of spinal.', 'hash': '641aa23206f255ba2443dcd69e67d9327d43c86943738d8318331f82420825bb'}, {'image_id': 'poljradiol-77-3-25-g010', 'image_file_name': 'poljradiol-77-3-25-g010.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g010.jpg', 'caption': 'CT – (A) transverse plane. (B) MPR reconstruction. (C) T2-weighted image, transverse plane. (D) T1-weighted + CM image, transverse plane. Right iliopsoas muscle abscesses.', 'hash': 'bf120396757c260157b48646714c84ad63a2bceff20df54fbace3eb668c78498'}, {'image_id': 'poljradiol-77-3-25-g009', 'image_file_name': 'poljradiol-77-3-25-g009.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g009.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T1-weighted + CM image, sagittal plane. (C) T2-weighted image, transverse plane. Follow-up after surgery. Spinal cord oedema, abscess between Th8 and Th9.', 'hash': 'e460bbb34372928a081fd29d6d61497496e96570cd547a011a305178fe4d3554'}, {'image_id': 'poljradiol-77-3-25-g007', 'image_file_name': 'poljradiol-77-3-25-g007.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g007.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. L2-L3 spondylodiscitis. Prevertebral abscess.', 'hash': 'c875b60fe5aad3d6c1738ea6be87b49c85d73d4a57c113c3cfc1b8a63ae49d09'}, {'image_id': 'poljradiol-77-3-25-g011', 'image_file_name': 'poljradiol-77-3-25-g011.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g011.jpg', 'caption': 'CT – (A) (B) MPR reconstructions. Subtotal destruction of Th8 vertebral body – vertebra plana. Compressive fractures of Th10 – Th12 vertebral bodies.', 'hash': 'eaeb39d42967d9f2c8547b5290933b788d3f4f6faf5c08e721fc1621078ce931'}] | {'poljradiol-77-3-25-g001': ['MR images revealed in all examined patients spondylodiscitis features within the vertebral bodies and/or intervertebral discs: high signal intensity of vertebral body marrow, and/or intervertebral discs on T2-weighted images and signal enhancement after contrast administration on T1-weighted images. In 7 patients contrast administration resulted in enhanced visibility of inter-canal pathological masses compressing the thecal sac and the spinal cord (<xref ref-type="fig" rid="poljradiol-77-3-25-g001">Figures 1</xref>, , <xref ref-type="fig" rid="poljradiol-77-3-25-g002">2</xref>).).'], 'poljradiol-77-3-25-g003': ['In one patient an abscess-like ring-enhancement lesion was detected in the apex of the left lung in a form of a round fluid filled cavity (<xref ref-type="fig" rid="poljradiol-77-3-25-g003">Figure 3</xref>).).'], 'poljradiol-77-3-25-g004': ['In three patients some fluid of pleural empyema character was noticed at the level of spinal inflammatory changes. In two cases it was unilateral (<xref ref-type="fig" rid="poljradiol-77-3-25-g004">Figures 4</xref>, , <xref ref-type="fig" rid="poljradiol-77-3-25-g005">5</xref>), and the third patient was diagnosed with bilateral pleural empyema (), and the third patient was diagnosed with bilateral pleural empyema (<xref ref-type="fig" rid="poljradiol-77-3-25-g006">Figure 6</xref>).).'], 'poljradiol-77-3-25-g007': ['The images from three patients showed fluid filled areas around spine and epidural space corresponding to a par-avertebral abscess (<xref ref-type="fig" rid="poljradiol-77-3-25-g007">Figure 7</xref>) and epidural empyemas () and epidural empyemas (<xref ref-type="fig" rid="poljradiol-77-3-25-g008">Figure 8</xref>).).'], 'poljradiol-77-3-25-g009': ['In one person from the study group a limited, ring-enhancement fluid lesion between the vertebral bodies – an intervertebral abscess (<xref ref-type="fig" rid="poljradiol-77-3-25-g009">Figure 9</xref>) was diagnosed.) was diagnosed.'], 'poljradiol-77-3-25-g010': ['In one patient fluid streaks visible at the level of inflammatory spinal changes turned out to be abscesses under the anterior longitudinal ligament, and in another patient - iliopsoas muscle abscesses (<xref ref-type="fig" rid="poljradiol-77-3-25-g010">Figure 10</xref>).).'], 'poljradiol-77-3-25-g011': ['All patients were diagnosed with various degrees of destruction of the affected vertebral bodies and the loss of end plate reduction and discontinuity of the cortical layer. Moreover, pathological fractures of vertebral bodies (<xref ref-type="fig" rid="poljradiol-77-3-25-g011">Figure 11</xref>) and liquefactive necrosis within one vertebral body were found in one of the patients () and liquefactive necrosis within one vertebral body were found in one of the patients (<xref ref-type="fig" rid="poljradiol-77-3-25-g012">Figure 12</xref>).).'], 'poljradiol-77-3-25-g013': ['Three patients underwent conservative treatment, and nine underwent surgical treatment (<xref ref-type="fig" rid="poljradiol-77-3-25-g013">Figure 13</xref>).).']} | Diagnostic difficulties resulting from morphological image variation in spondylodiscitis MR imaging | [
"spondylodiscitis",
"discitis",
"discovertebral junction"
] | Pol J Radiol | 1341126000 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'Spinal infection (discitis; spondylodiscitis) presents a wide spectrum of pathologies. The method of choice for spondylodiscitis imaging is magnetic resonance (MR). It provides detailed anatomical information, especially concerning epidural space and spinal cord. The main aim of this article is the description and evaluation of spondylodiscitis morphological variation visible in magnetic resonance imaging.'}, {'@Label': 'MATERIAL/METHODS', '@NlmCategory': 'METHODS', '#text': 'In this article we retrospectively analysed the patients diagnosed at the Department of Radiology of the Provincial Hospital No 2 in Rzeszów between October 2009 and October 2011. The subjects involved a group of five women aged 41-74 (mean 56.3 years) and eight men aged 46-69 (mean 61,3 years). All patients had spondylodiscitis symptoms. All patients underwent MRI examination before and after the contrast enhancement. In three patients additional CT examination was performed.'}, {'@Label': 'RESULTS', '@NlmCategory': 'RESULTS', '#text': 'Following the MRI procedure all patients were diagnosed with typical symptoms of spondylodiscitis. It also revealed a number of pathologies resulting from morphological spondylodiscitis variation. Other pathologies found on the MR images of the study group patients involved epidural intra-canal spinal pathological masses causing spinal cord compression, lung abscess, pyothorax, paravertebral abscesses and epidural empyemas, abscess between adjacent vertebral bodies, abscesses beneath anterior longitudinal ligament, and iliopsoas muscle abscesses. In all cases a destruction of vertebral bodies with end plates loss restriction and cortical layer discontinuity was observed. Moreover, one person was diagnosed with pathological vertebral body fractures and liquefactive necrosis of the vertebral body.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'Spondylodiscitis manifests itself in a great number of morphological variations visible on the radiological images. Apart from ordinary features of vertebral bodies and discs, progressive spinal destruction is observed together with reactive bone changes and soft tissue infiltration. The latter leads to a number of complications e.g. abscesses or even fistulas and also to the formation of obstacles in radiological images. The knowledge of radiological images together with overall evaluation of clinical and laboratory features enables a proper diagnosis.'}] | [] | other | PMC3447430 | null | 17 | [
"{'Citation': 'Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010;65(3):11–24.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20876624'}}}",
"{'Citation': 'Tali ET. Spinal infections. Eur J Radiol. 2004;50(2):120–33.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15081128'}}}",
"{'Citation': 'Łukjanowicz M, Bohatyrewicz A, Brzosko M. Zapalenie kręgosłupa wywołane przez drożdże z rodzaju Candida – przegląd piśmiennictwa. Ann Acad Med Stetin. 2007;53(3):128–33. [in Polish]', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18595495'}}}",
"{'Citation': 'Hennequin C, Bouree P, Hiesse C, et al. Spondylodiskitis due to Candida albicans: report of two patients who were successfully treated with fluconazole and review of the literature. Clin Infect Dis. 1996;23(1):176–78.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8816150'}}}",
"{'Citation': 'Miller DJ, Mejicano GC. Vertebral osteomyelitis due to Candida species: case report and literature review. Clin Infect Dis. 2001;33(4):523–30.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11462190'}}}",
"{'Citation': 'Titlic M, Josipovic-Jelic Z. Spondylodiscitis. Bratist Lek Listy. 2008;109(8):345–47.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18837241'}}}",
"{'Citation': 'Longo M, Granata F, Gaeta M, et al. Contrast-enhanced MR imaging with fat suppression in adult-onset septic spondylodiscitis. Eur Radiol. 2003;13(3):626–37.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12594568'}}}",
"{'Citation': 'Bruzzese V. Spondylodiscitis as the only clinical manifestation of the onset of psoriatic spondyloarthritis. Reumatismo. 2011;63(1):38–43.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21509348'}}}",
"{'Citation': 'Grammatico L, Besnier JM. Infection spondylodiscitis. Rev Prat. 2007;57(9):970–78.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17695676'}}}",
"{'Citation': 'Jinkins JR, Bazan C, III, Xiong L. MR of disc protrusion engendered by infectious spondylitis. J Comput Assist Tomogr. 1996;20(5):715–18.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8797899'}}}",
"{'Citation': 'Reijnierse M, Dijkmans BA, Hansen B, et al. Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters. Eur Radiol. 2001;11(3):467–73.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11288854'}}}",
"{'Citation': 'Chelsom J, Solberg CO. Vertebral osteomyelitis at a Norwegian university hospital 1987–97: clinical features, laboratory findings and outcome. Scand J Infect Dis. 1998;30(2):147–51.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9730301'}}}",
"{'Citation': 'Jevtic V. Vertebral infection. Eur Radiol. 2004;14(3):43–52.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14749956'}}}",
"{'Citation': 'Gemmel F, Dumarey N, Palestro CJ. Radionuclide imaging of spinal infections. Eur J Nucl Med Mol Imaging. 2006;33(10):1226–37.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16896656'}}}",
"{'Citation': 'Maiuri F, Iaconetta G, Gallicchio B, et al. Sondylodiscitis. Clinical and magnetic resonance diagnosis. Spine. 1997;22(15):1741–46.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9259785'}}}",
"{'Citation': 'Ledermann HP, Schweitzer ME, Morrison WB, et al. MR imaging findings in spinal infections: rules or myths? Radiology. 2003;228(2):506–14.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12802004'}}}",
"{'Citation': 'Hadjipavlou AG, Katonis PK, Gaitanis IN, et al. Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis. Eur Spine J. 2004;13(8):707–13.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3454057'}, {'@IdType': 'pubmed', '#text': '15197626'}]}}"
] | Pol J Radiol. 2012 Jul-Sep; 77(3):25-34 | NO-CC CODE |
|
(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. Contrast enhancement of paravertebral and epidural intra-canal spinal pathological mass. | poljradiol-77-3-25-g002 | 7 | 0493ee11e5e6fd053cb2d95add5425b56a01bb5bccaf9993477f3504e34152e2 | poljradiol-77-3-25-g002.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
720,
364
] | [{'image_id': 'poljradiol-77-3-25-g012', 'image_file_name': 'poljradiol-77-3-25-g012.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g012.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T2-weighted image, transverse plane. Th7–Th9 spondylodiscitis, high signal intensity of the bone marrow of Th7 and Th9 vertebral bodies and high signal of intervertebral discs, high signal – liquefactive necrosis – of subtotally destructed Th8 vertebral body – spinal cord compression.', 'hash': 'bec03301650da7545df8934b48bdbe9e82292b9c4907169f2969fe1e8d392c70'}, {'image_id': 'poljradiol-77-3-25-g004', 'image_file_name': 'poljradiol-77-3-25-g004.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g004.jpg', 'caption': '(A) T2-weighted image, transverse plane. (B) T1-weighted + CM image, transverse plane. Right pyothorax. Contrast enhancement of paravertebral pathological mass.', 'hash': '271069e7ac2ad23fe2dcd3299a9c9ca53480a7be9055a5acf575bfb8e21853b2'}, {'image_id': 'poljradiol-77-3-25-g003', 'image_file_name': 'poljradiol-77-3-25-g003.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g003.jpg', 'caption': '(A) T2-weighted image, frontal plane. (B) T1-weighted + CM image, frontal plane. Cavity in the apex of the left lung.', 'hash': 'f8b7f609049ccd4a3f35d67d34246d0830e54b904489c7bc1ea2a682ea118bf4'}, {'image_id': 'poljradiol-77-3-25-g013', 'image_file_name': 'poljradiol-77-3-25-g013.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g013.jpg', 'caption': 'Follow-up CT after surgery. MPR reconstruction.', 'hash': '1c92505e64cea4970fe4576039df64b4e88dc4967518cd39c563fb8638653588'}, {'image_id': 'poljradiol-77-3-25-g002', 'image_file_name': 'poljradiol-77-3-25-g002.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g002.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. Contrast enhancement of paravertebral and epidural intra-canal spinal pathological mass.', 'hash': '0493ee11e5e6fd053cb2d95add5425b56a01bb5bccaf9993477f3504e34152e2'}, {'image_id': 'poljradiol-77-3-25-g005', 'image_file_name': 'poljradiol-77-3-25-g005.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g005.jpg', 'caption': 'CT + CM. (A) transverse plane. (B) MPR reconstruction. Left pyothorax.', 'hash': '66c91bf53ccb5c921c966774ad28157f805e29d43dda5f5ddb853850895e27ce'}, {'image_id': 'poljradiol-77-3-25-g006', 'image_file_name': 'poljradiol-77-3-25-g006.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g006.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. (C) T1-weighted + CM image, frontal plane. Contrast enhancement of paravertebral and epidural intra-canal pathological mass. Bilateral pyothorax.', 'hash': '52899467ba638bc7ea62236efbcd16e97b4952ffd2cd8b49a8cc8087ba876fba'}, {'image_id': 'poljradiol-77-3-25-g001', 'image_file_name': 'poljradiol-77-3-25-g001.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g001.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T2-weighted image, transverse plane. C5–C7 spondylodiscitis, high signal intensity of the bone marrow of vertebral bodies and high signal intensity of intervertebral discs with destruction of C6 vertebral body, spinal cord compression.', 'hash': 'cc1ced72b197a6d97fd6959c122f6b25e9cf0abee6728c4689ee4877736bac1e'}, {'image_id': 'poljradiol-77-3-25-g008', 'image_file_name': 'poljradiol-77-3-25-g008.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g008.jpg', 'caption': 'T1-weighted + CM image, sagittal plane. Contrast enhancement of paravertebral pathological mass. Epidural empyema in the cervical and thoracic part of spinal.', 'hash': '641aa23206f255ba2443dcd69e67d9327d43c86943738d8318331f82420825bb'}, {'image_id': 'poljradiol-77-3-25-g010', 'image_file_name': 'poljradiol-77-3-25-g010.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g010.jpg', 'caption': 'CT – (A) transverse plane. (B) MPR reconstruction. (C) T2-weighted image, transverse plane. (D) T1-weighted + CM image, transverse plane. Right iliopsoas muscle abscesses.', 'hash': 'bf120396757c260157b48646714c84ad63a2bceff20df54fbace3eb668c78498'}, {'image_id': 'poljradiol-77-3-25-g009', 'image_file_name': 'poljradiol-77-3-25-g009.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g009.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T1-weighted + CM image, sagittal plane. (C) T2-weighted image, transverse plane. Follow-up after surgery. Spinal cord oedema, abscess between Th8 and Th9.', 'hash': 'e460bbb34372928a081fd29d6d61497496e96570cd547a011a305178fe4d3554'}, {'image_id': 'poljradiol-77-3-25-g007', 'image_file_name': 'poljradiol-77-3-25-g007.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g007.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. L2-L3 spondylodiscitis. Prevertebral abscess.', 'hash': 'c875b60fe5aad3d6c1738ea6be87b49c85d73d4a57c113c3cfc1b8a63ae49d09'}, {'image_id': 'poljradiol-77-3-25-g011', 'image_file_name': 'poljradiol-77-3-25-g011.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g011.jpg', 'caption': 'CT – (A) (B) MPR reconstructions. Subtotal destruction of Th8 vertebral body – vertebra plana. Compressive fractures of Th10 – Th12 vertebral bodies.', 'hash': 'eaeb39d42967d9f2c8547b5290933b788d3f4f6faf5c08e721fc1621078ce931'}] | {'poljradiol-77-3-25-g001': ['MR images revealed in all examined patients spondylodiscitis features within the vertebral bodies and/or intervertebral discs: high signal intensity of vertebral body marrow, and/or intervertebral discs on T2-weighted images and signal enhancement after contrast administration on T1-weighted images. In 7 patients contrast administration resulted in enhanced visibility of inter-canal pathological masses compressing the thecal sac and the spinal cord (<xref ref-type="fig" rid="poljradiol-77-3-25-g001">Figures 1</xref>, , <xref ref-type="fig" rid="poljradiol-77-3-25-g002">2</xref>).).'], 'poljradiol-77-3-25-g003': ['In one patient an abscess-like ring-enhancement lesion was detected in the apex of the left lung in a form of a round fluid filled cavity (<xref ref-type="fig" rid="poljradiol-77-3-25-g003">Figure 3</xref>).).'], 'poljradiol-77-3-25-g004': ['In three patients some fluid of pleural empyema character was noticed at the level of spinal inflammatory changes. In two cases it was unilateral (<xref ref-type="fig" rid="poljradiol-77-3-25-g004">Figures 4</xref>, , <xref ref-type="fig" rid="poljradiol-77-3-25-g005">5</xref>), and the third patient was diagnosed with bilateral pleural empyema (), and the third patient was diagnosed with bilateral pleural empyema (<xref ref-type="fig" rid="poljradiol-77-3-25-g006">Figure 6</xref>).).'], 'poljradiol-77-3-25-g007': ['The images from three patients showed fluid filled areas around spine and epidural space corresponding to a par-avertebral abscess (<xref ref-type="fig" rid="poljradiol-77-3-25-g007">Figure 7</xref>) and epidural empyemas () and epidural empyemas (<xref ref-type="fig" rid="poljradiol-77-3-25-g008">Figure 8</xref>).).'], 'poljradiol-77-3-25-g009': ['In one person from the study group a limited, ring-enhancement fluid lesion between the vertebral bodies – an intervertebral abscess (<xref ref-type="fig" rid="poljradiol-77-3-25-g009">Figure 9</xref>) was diagnosed.) was diagnosed.'], 'poljradiol-77-3-25-g010': ['In one patient fluid streaks visible at the level of inflammatory spinal changes turned out to be abscesses under the anterior longitudinal ligament, and in another patient - iliopsoas muscle abscesses (<xref ref-type="fig" rid="poljradiol-77-3-25-g010">Figure 10</xref>).).'], 'poljradiol-77-3-25-g011': ['All patients were diagnosed with various degrees of destruction of the affected vertebral bodies and the loss of end plate reduction and discontinuity of the cortical layer. Moreover, pathological fractures of vertebral bodies (<xref ref-type="fig" rid="poljradiol-77-3-25-g011">Figure 11</xref>) and liquefactive necrosis within one vertebral body were found in one of the patients () and liquefactive necrosis within one vertebral body were found in one of the patients (<xref ref-type="fig" rid="poljradiol-77-3-25-g012">Figure 12</xref>).).'], 'poljradiol-77-3-25-g013': ['Three patients underwent conservative treatment, and nine underwent surgical treatment (<xref ref-type="fig" rid="poljradiol-77-3-25-g013">Figure 13</xref>).).']} | Diagnostic difficulties resulting from morphological image variation in spondylodiscitis MR imaging | [
"spondylodiscitis",
"discitis",
"discovertebral junction"
] | Pol J Radiol | 1341126000 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'Spinal infection (discitis; spondylodiscitis) presents a wide spectrum of pathologies. The method of choice for spondylodiscitis imaging is magnetic resonance (MR). It provides detailed anatomical information, especially concerning epidural space and spinal cord. The main aim of this article is the description and evaluation of spondylodiscitis morphological variation visible in magnetic resonance imaging.'}, {'@Label': 'MATERIAL/METHODS', '@NlmCategory': 'METHODS', '#text': 'In this article we retrospectively analysed the patients diagnosed at the Department of Radiology of the Provincial Hospital No 2 in Rzeszów between October 2009 and October 2011. The subjects involved a group of five women aged 41-74 (mean 56.3 years) and eight men aged 46-69 (mean 61,3 years). All patients had spondylodiscitis symptoms. All patients underwent MRI examination before and after the contrast enhancement. In three patients additional CT examination was performed.'}, {'@Label': 'RESULTS', '@NlmCategory': 'RESULTS', '#text': 'Following the MRI procedure all patients were diagnosed with typical symptoms of spondylodiscitis. It also revealed a number of pathologies resulting from morphological spondylodiscitis variation. Other pathologies found on the MR images of the study group patients involved epidural intra-canal spinal pathological masses causing spinal cord compression, lung abscess, pyothorax, paravertebral abscesses and epidural empyemas, abscess between adjacent vertebral bodies, abscesses beneath anterior longitudinal ligament, and iliopsoas muscle abscesses. In all cases a destruction of vertebral bodies with end plates loss restriction and cortical layer discontinuity was observed. Moreover, one person was diagnosed with pathological vertebral body fractures and liquefactive necrosis of the vertebral body.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'Spondylodiscitis manifests itself in a great number of morphological variations visible on the radiological images. Apart from ordinary features of vertebral bodies and discs, progressive spinal destruction is observed together with reactive bone changes and soft tissue infiltration. The latter leads to a number of complications e.g. abscesses or even fistulas and also to the formation of obstacles in radiological images. The knowledge of radiological images together with overall evaluation of clinical and laboratory features enables a proper diagnosis.'}] | [] | other | PMC3447430 | null | 17 | [
"{'Citation': 'Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010;65(3):11–24.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20876624'}}}",
"{'Citation': 'Tali ET. Spinal infections. Eur J Radiol. 2004;50(2):120–33.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15081128'}}}",
"{'Citation': 'Łukjanowicz M, Bohatyrewicz A, Brzosko M. Zapalenie kręgosłupa wywołane przez drożdże z rodzaju Candida – przegląd piśmiennictwa. Ann Acad Med Stetin. 2007;53(3):128–33. [in Polish]', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18595495'}}}",
"{'Citation': 'Hennequin C, Bouree P, Hiesse C, et al. Spondylodiskitis due to Candida albicans: report of two patients who were successfully treated with fluconazole and review of the literature. Clin Infect Dis. 1996;23(1):176–78.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8816150'}}}",
"{'Citation': 'Miller DJ, Mejicano GC. Vertebral osteomyelitis due to Candida species: case report and literature review. Clin Infect Dis. 2001;33(4):523–30.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11462190'}}}",
"{'Citation': 'Titlic M, Josipovic-Jelic Z. Spondylodiscitis. Bratist Lek Listy. 2008;109(8):345–47.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18837241'}}}",
"{'Citation': 'Longo M, Granata F, Gaeta M, et al. Contrast-enhanced MR imaging with fat suppression in adult-onset septic spondylodiscitis. Eur Radiol. 2003;13(3):626–37.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12594568'}}}",
"{'Citation': 'Bruzzese V. Spondylodiscitis as the only clinical manifestation of the onset of psoriatic spondyloarthritis. Reumatismo. 2011;63(1):38–43.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21509348'}}}",
"{'Citation': 'Grammatico L, Besnier JM. Infection spondylodiscitis. Rev Prat. 2007;57(9):970–78.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17695676'}}}",
"{'Citation': 'Jinkins JR, Bazan C, III, Xiong L. MR of disc protrusion engendered by infectious spondylitis. J Comput Assist Tomogr. 1996;20(5):715–18.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8797899'}}}",
"{'Citation': 'Reijnierse M, Dijkmans BA, Hansen B, et al. Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters. Eur Radiol. 2001;11(3):467–73.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11288854'}}}",
"{'Citation': 'Chelsom J, Solberg CO. Vertebral osteomyelitis at a Norwegian university hospital 1987–97: clinical features, laboratory findings and outcome. Scand J Infect Dis. 1998;30(2):147–51.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9730301'}}}",
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] | Pol J Radiol. 2012 Jul-Sep; 77(3):25-34 | NO-CC CODE |
|
CT – (A) (B) MPR reconstructions. Subtotal destruction of Th8 vertebral body – vertebra plana. Compressive fractures of Th10 – Th12 vertebral bodies. | poljradiol-77-3-25-g011 | 7 | eaeb39d42967d9f2c8547b5290933b788d3f4f6faf5c08e721fc1621078ce931 | poljradiol-77-3-25-g011.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
720,
434
] | [{'image_id': 'poljradiol-77-3-25-g012', 'image_file_name': 'poljradiol-77-3-25-g012.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g012.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T2-weighted image, transverse plane. Th7–Th9 spondylodiscitis, high signal intensity of the bone marrow of Th7 and Th9 vertebral bodies and high signal of intervertebral discs, high signal – liquefactive necrosis – of subtotally destructed Th8 vertebral body – spinal cord compression.', 'hash': 'bec03301650da7545df8934b48bdbe9e82292b9c4907169f2969fe1e8d392c70'}, {'image_id': 'poljradiol-77-3-25-g004', 'image_file_name': 'poljradiol-77-3-25-g004.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g004.jpg', 'caption': '(A) T2-weighted image, transverse plane. (B) T1-weighted + CM image, transverse plane. Right pyothorax. Contrast enhancement of paravertebral pathological mass.', 'hash': '271069e7ac2ad23fe2dcd3299a9c9ca53480a7be9055a5acf575bfb8e21853b2'}, {'image_id': 'poljradiol-77-3-25-g003', 'image_file_name': 'poljradiol-77-3-25-g003.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g003.jpg', 'caption': '(A) T2-weighted image, frontal plane. (B) T1-weighted + CM image, frontal plane. Cavity in the apex of the left lung.', 'hash': 'f8b7f609049ccd4a3f35d67d34246d0830e54b904489c7bc1ea2a682ea118bf4'}, {'image_id': 'poljradiol-77-3-25-g013', 'image_file_name': 'poljradiol-77-3-25-g013.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g013.jpg', 'caption': 'Follow-up CT after surgery. MPR reconstruction.', 'hash': '1c92505e64cea4970fe4576039df64b4e88dc4967518cd39c563fb8638653588'}, {'image_id': 'poljradiol-77-3-25-g002', 'image_file_name': 'poljradiol-77-3-25-g002.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g002.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. Contrast enhancement of paravertebral and epidural intra-canal spinal pathological mass.', 'hash': '0493ee11e5e6fd053cb2d95add5425b56a01bb5bccaf9993477f3504e34152e2'}, {'image_id': 'poljradiol-77-3-25-g005', 'image_file_name': 'poljradiol-77-3-25-g005.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g005.jpg', 'caption': 'CT + CM. (A) transverse plane. (B) MPR reconstruction. Left pyothorax.', 'hash': '66c91bf53ccb5c921c966774ad28157f805e29d43dda5f5ddb853850895e27ce'}, {'image_id': 'poljradiol-77-3-25-g006', 'image_file_name': 'poljradiol-77-3-25-g006.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g006.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. (C) T1-weighted + CM image, frontal plane. Contrast enhancement of paravertebral and epidural intra-canal pathological mass. Bilateral pyothorax.', 'hash': '52899467ba638bc7ea62236efbcd16e97b4952ffd2cd8b49a8cc8087ba876fba'}, {'image_id': 'poljradiol-77-3-25-g001', 'image_file_name': 'poljradiol-77-3-25-g001.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g001.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T2-weighted image, transverse plane. C5–C7 spondylodiscitis, high signal intensity of the bone marrow of vertebral bodies and high signal intensity of intervertebral discs with destruction of C6 vertebral body, spinal cord compression.', 'hash': 'cc1ced72b197a6d97fd6959c122f6b25e9cf0abee6728c4689ee4877736bac1e'}, {'image_id': 'poljradiol-77-3-25-g008', 'image_file_name': 'poljradiol-77-3-25-g008.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g008.jpg', 'caption': 'T1-weighted + CM image, sagittal plane. Contrast enhancement of paravertebral pathological mass. Epidural empyema in the cervical and thoracic part of spinal.', 'hash': '641aa23206f255ba2443dcd69e67d9327d43c86943738d8318331f82420825bb'}, {'image_id': 'poljradiol-77-3-25-g010', 'image_file_name': 'poljradiol-77-3-25-g010.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g010.jpg', 'caption': 'CT – (A) transverse plane. (B) MPR reconstruction. (C) T2-weighted image, transverse plane. (D) T1-weighted + CM image, transverse plane. Right iliopsoas muscle abscesses.', 'hash': 'bf120396757c260157b48646714c84ad63a2bceff20df54fbace3eb668c78498'}, {'image_id': 'poljradiol-77-3-25-g009', 'image_file_name': 'poljradiol-77-3-25-g009.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g009.jpg', 'caption': '(A) T2-weighted image, sagittal plane. (B) T1-weighted + CM image, sagittal plane. (C) T2-weighted image, transverse plane. Follow-up after surgery. Spinal cord oedema, abscess between Th8 and Th9.', 'hash': 'e460bbb34372928a081fd29d6d61497496e96570cd547a011a305178fe4d3554'}, {'image_id': 'poljradiol-77-3-25-g007', 'image_file_name': 'poljradiol-77-3-25-g007.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g007.jpg', 'caption': '(A) T1-weighted + CM image, sagittal plane. (B) T1-weighted + CM image, transverse plane. L2-L3 spondylodiscitis. Prevertebral abscess.', 'hash': 'c875b60fe5aad3d6c1738ea6be87b49c85d73d4a57c113c3cfc1b8a63ae49d09'}, {'image_id': 'poljradiol-77-3-25-g011', 'image_file_name': 'poljradiol-77-3-25-g011.jpg', 'image_path': '../data/media_files/PMC3447430/poljradiol-77-3-25-g011.jpg', 'caption': 'CT – (A) (B) MPR reconstructions. Subtotal destruction of Th8 vertebral body – vertebra plana. Compressive fractures of Th10 – Th12 vertebral bodies.', 'hash': 'eaeb39d42967d9f2c8547b5290933b788d3f4f6faf5c08e721fc1621078ce931'}] | {'poljradiol-77-3-25-g001': ['MR images revealed in all examined patients spondylodiscitis features within the vertebral bodies and/or intervertebral discs: high signal intensity of vertebral body marrow, and/or intervertebral discs on T2-weighted images and signal enhancement after contrast administration on T1-weighted images. In 7 patients contrast administration resulted in enhanced visibility of inter-canal pathological masses compressing the thecal sac and the spinal cord (<xref ref-type="fig" rid="poljradiol-77-3-25-g001">Figures 1</xref>, , <xref ref-type="fig" rid="poljradiol-77-3-25-g002">2</xref>).).'], 'poljradiol-77-3-25-g003': ['In one patient an abscess-like ring-enhancement lesion was detected in the apex of the left lung in a form of a round fluid filled cavity (<xref ref-type="fig" rid="poljradiol-77-3-25-g003">Figure 3</xref>).).'], 'poljradiol-77-3-25-g004': ['In three patients some fluid of pleural empyema character was noticed at the level of spinal inflammatory changes. In two cases it was unilateral (<xref ref-type="fig" rid="poljradiol-77-3-25-g004">Figures 4</xref>, , <xref ref-type="fig" rid="poljradiol-77-3-25-g005">5</xref>), and the third patient was diagnosed with bilateral pleural empyema (), and the third patient was diagnosed with bilateral pleural empyema (<xref ref-type="fig" rid="poljradiol-77-3-25-g006">Figure 6</xref>).).'], 'poljradiol-77-3-25-g007': ['The images from three patients showed fluid filled areas around spine and epidural space corresponding to a par-avertebral abscess (<xref ref-type="fig" rid="poljradiol-77-3-25-g007">Figure 7</xref>) and epidural empyemas () and epidural empyemas (<xref ref-type="fig" rid="poljradiol-77-3-25-g008">Figure 8</xref>).).'], 'poljradiol-77-3-25-g009': ['In one person from the study group a limited, ring-enhancement fluid lesion between the vertebral bodies – an intervertebral abscess (<xref ref-type="fig" rid="poljradiol-77-3-25-g009">Figure 9</xref>) was diagnosed.) was diagnosed.'], 'poljradiol-77-3-25-g010': ['In one patient fluid streaks visible at the level of inflammatory spinal changes turned out to be abscesses under the anterior longitudinal ligament, and in another patient - iliopsoas muscle abscesses (<xref ref-type="fig" rid="poljradiol-77-3-25-g010">Figure 10</xref>).).'], 'poljradiol-77-3-25-g011': ['All patients were diagnosed with various degrees of destruction of the affected vertebral bodies and the loss of end plate reduction and discontinuity of the cortical layer. Moreover, pathological fractures of vertebral bodies (<xref ref-type="fig" rid="poljradiol-77-3-25-g011">Figure 11</xref>) and liquefactive necrosis within one vertebral body were found in one of the patients () and liquefactive necrosis within one vertebral body were found in one of the patients (<xref ref-type="fig" rid="poljradiol-77-3-25-g012">Figure 12</xref>).).'], 'poljradiol-77-3-25-g013': ['Three patients underwent conservative treatment, and nine underwent surgical treatment (<xref ref-type="fig" rid="poljradiol-77-3-25-g013">Figure 13</xref>).).']} | Diagnostic difficulties resulting from morphological image variation in spondylodiscitis MR imaging | [
"spondylodiscitis",
"discitis",
"discovertebral junction"
] | Pol J Radiol | 1341126000 | [{'@Label': 'BACKGROUND', '@NlmCategory': 'BACKGROUND', '#text': 'Spinal infection (discitis; spondylodiscitis) presents a wide spectrum of pathologies. The method of choice for spondylodiscitis imaging is magnetic resonance (MR). It provides detailed anatomical information, especially concerning epidural space and spinal cord. The main aim of this article is the description and evaluation of spondylodiscitis morphological variation visible in magnetic resonance imaging.'}, {'@Label': 'MATERIAL/METHODS', '@NlmCategory': 'METHODS', '#text': 'In this article we retrospectively analysed the patients diagnosed at the Department of Radiology of the Provincial Hospital No 2 in Rzeszów between October 2009 and October 2011. The subjects involved a group of five women aged 41-74 (mean 56.3 years) and eight men aged 46-69 (mean 61,3 years). All patients had spondylodiscitis symptoms. All patients underwent MRI examination before and after the contrast enhancement. In three patients additional CT examination was performed.'}, {'@Label': 'RESULTS', '@NlmCategory': 'RESULTS', '#text': 'Following the MRI procedure all patients were diagnosed with typical symptoms of spondylodiscitis. It also revealed a number of pathologies resulting from morphological spondylodiscitis variation. Other pathologies found on the MR images of the study group patients involved epidural intra-canal spinal pathological masses causing spinal cord compression, lung abscess, pyothorax, paravertebral abscesses and epidural empyemas, abscess between adjacent vertebral bodies, abscesses beneath anterior longitudinal ligament, and iliopsoas muscle abscesses. In all cases a destruction of vertebral bodies with end plates loss restriction and cortical layer discontinuity was observed. Moreover, one person was diagnosed with pathological vertebral body fractures and liquefactive necrosis of the vertebral body.'}, {'@Label': 'CONCLUSIONS', '@NlmCategory': 'CONCLUSIONS', '#text': 'Spondylodiscitis manifests itself in a great number of morphological variations visible on the radiological images. Apart from ordinary features of vertebral bodies and discs, progressive spinal destruction is observed together with reactive bone changes and soft tissue infiltration. The latter leads to a number of complications e.g. abscesses or even fistulas and also to the formation of obstacles in radiological images. The knowledge of radiological images together with overall evaluation of clinical and laboratory features enables a proper diagnosis.'}] | [] | other | PMC3447430 | null | 17 | [
"{'Citation': 'Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010;65(3):11–24.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '20876624'}}}",
"{'Citation': 'Tali ET. Spinal infections. Eur J Radiol. 2004;50(2):120–33.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '15081128'}}}",
"{'Citation': 'Łukjanowicz M, Bohatyrewicz A, Brzosko M. Zapalenie kręgosłupa wywołane przez drożdże z rodzaju Candida – przegląd piśmiennictwa. Ann Acad Med Stetin. 2007;53(3):128–33. [in Polish]', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18595495'}}}",
"{'Citation': 'Hennequin C, Bouree P, Hiesse C, et al. Spondylodiskitis due to Candida albicans: report of two patients who were successfully treated with fluconazole and review of the literature. Clin Infect Dis. 1996;23(1):176–78.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8816150'}}}",
"{'Citation': 'Miller DJ, Mejicano GC. Vertebral osteomyelitis due to Candida species: case report and literature review. Clin Infect Dis. 2001;33(4):523–30.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11462190'}}}",
"{'Citation': 'Titlic M, Josipovic-Jelic Z. Spondylodiscitis. Bratist Lek Listy. 2008;109(8):345–47.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18837241'}}}",
"{'Citation': 'Longo M, Granata F, Gaeta M, et al. Contrast-enhanced MR imaging with fat suppression in adult-onset septic spondylodiscitis. Eur Radiol. 2003;13(3):626–37.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12594568'}}}",
"{'Citation': 'Bruzzese V. Spondylodiscitis as the only clinical manifestation of the onset of psoriatic spondyloarthritis. Reumatismo. 2011;63(1):38–43.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '21509348'}}}",
"{'Citation': 'Grammatico L, Besnier JM. Infection spondylodiscitis. Rev Prat. 2007;57(9):970–78.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17695676'}}}",
"{'Citation': 'Jinkins JR, Bazan C, III, Xiong L. MR of disc protrusion engendered by infectious spondylitis. J Comput Assist Tomogr. 1996;20(5):715–18.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8797899'}}}",
"{'Citation': 'Reijnierse M, Dijkmans BA, Hansen B, et al. Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters. Eur Radiol. 2001;11(3):467–73.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11288854'}}}",
"{'Citation': 'Chelsom J, Solberg CO. Vertebral osteomyelitis at a Norwegian university hospital 1987–97: clinical features, laboratory findings and outcome. Scand J Infect Dis. 1998;30(2):147–51.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9730301'}}}",
"{'Citation': 'Jevtic V. Vertebral infection. Eur Radiol. 2004;14(3):43–52.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14749956'}}}",
"{'Citation': 'Gemmel F, Dumarey N, Palestro CJ. Radionuclide imaging of spinal infections. Eur J Nucl Med Mol Imaging. 2006;33(10):1226–37.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '16896656'}}}",
"{'Citation': 'Maiuri F, Iaconetta G, Gallicchio B, et al. Sondylodiscitis. Clinical and magnetic resonance diagnosis. Spine. 1997;22(15):1741–46.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9259785'}}}",
"{'Citation': 'Ledermann HP, Schweitzer ME, Morrison WB, et al. MR imaging findings in spinal infections: rules or myths? Radiology. 2003;228(2):506–14.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12802004'}}}",
"{'Citation': 'Hadjipavlou AG, Katonis PK, Gaitanis IN, et al. Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis. Eur Spine J. 2004;13(8):707–13.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3454057'}, {'@IdType': 'pubmed', '#text': '15197626'}]}}"
] | Pol J Radiol. 2012 Jul-Sep; 77(3):25-34 | NO-CC CODE |
|
Pneumonia with CMV etiology. The high definition CT shows numerous but not well visible mid-lobule nodules. | poljradiol-77-3-64-g004 | 7 | c365e7f8da20cced063c2b22adc68fe645bd2b8115f02fa83d5e39ab698b3f21 | poljradiol-77-3-64-g004.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
600,
449
] | [{'image_id': 'poljradiol-77-3-64-g002', 'image_file_name': 'poljradiol-77-3-64-g002.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g002.jpg', 'caption': 'Pneumonia with Klebsiella pneumonice etiology. The high definition CT shows unified parenchyma congestions with air bronchogram located in the bottom lobe of the left lung (A). The sectional view includes (left side) the visible space between lobes (B).', 'hash': '14f386e258f39959bb079158bc61e13080cbf42a4e0315f29826b2f06aa9a0ee'}, {'image_id': 'poljradiol-77-3-64-g005', 'image_file_name': 'poljradiol-77-3-64-g005.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g005.jpg', 'caption': 'Pneumonia with the mixed etiology: flu and Pseudomonas aeruginosa. The high definition CT shows spread areas of the ‘dim glass’, alveolar congestions and individual nodules forming an image of the tree-in bud.', 'hash': 'a3dbb4c0ee23bd511fe565c51eeed241877941aff1d00c1424ea330fe650edfd'}, {'image_id': 'poljradiol-77-3-64-g004', 'image_file_name': 'poljradiol-77-3-64-g004.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g004.jpg', 'caption': 'Pneumonia with CMV etiology. The high definition CT shows numerous but not well visible mid-lobule nodules.', 'hash': 'c365e7f8da20cced063c2b22adc68fe645bd2b8115f02fa83d5e39ab698b3f21'}, {'image_id': 'poljradiol-77-3-64-g003', 'image_file_name': 'poljradiol-77-3-64-g003.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g003.jpg', 'caption': 'TB pneumonia. The chest imaging P-A shows a cavity with thick walls in the upper part of the right lung with the parenchyma congestions and bronchial thickening in the central and bottom part of the right lung (A). The high definition CT of this patient shows cavity with thick walls including aspergilloma in the upper part of the right lung, there is also thickening of pleura on its level and alveolar congestions in the surrounding parenchyma (B). There are also spread tree-in bud changes in the parenchyma of the right lung (C). CT of another patient shows bottom trachea lymph gland with the central necrosis and contrast in the circuit (D).', 'hash': 'a62b095b883df2f13a1f5d5c9aaaabcdd76d51f5666b81360bd1b11228e6e9cb'}, {'image_id': 'poljradiol-77-3-64-g007', 'image_file_name': 'poljradiol-77-3-64-g007.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g007.jpg', 'caption': 'Pneumocystosis pneumonia (PCP). The chest imaging A-P of the intubated patient presents bilateral linear changes in central parenchyma (A). The high definition CT of this patient shows massive spread gruond-glass attenuation located in both lungs and minor cystic changes – pneumatocele – mainly in the upper lobes of both lungs (B).', 'hash': 'c48af0d422e8d75ce1928dff6b6b2ba955cd1902996f7bc4a3afba719a8f06af'}, {'image_id': 'poljradiol-77-3-64-g008', 'image_file_name': 'poljradiol-77-3-64-g008.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g008.jpg', 'caption': 'Pulmonary candidiasis pneumonia. The high definition CT shows numerous minor, well-separated nodules in both lower lung lobes.', 'hash': '02188f49829f5bade387aafbdad92635beac0d6e53ac75f423a66bc4e1200543'}, {'image_id': 'poljradiol-77-3-64-g006', 'image_file_name': 'poljradiol-77-3-64-g006.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g006.jpg', 'caption': 'Angio-invasive form of aspergillosis. The high definition CT shows in the bottom left lung parenchyma congestions surrounded by the edging of the ‘dim glass’ – halo sign (A). The high definition CT of another patient during the period of the clinical improvement showed nodules surrounded by the air edging (B).', 'hash': 'fccc4cfd2561d6c8183ae433af360a4d5ff1ac5f8aac17760e1b8f9b3d1dfe21'}, {'image_id': 'poljradiol-77-3-64-g001', 'image_file_name': 'poljradiol-77-3-64-g001.jpg', 'image_path': '../data/media_files/PMC3447437/poljradiol-77-3-64-g001.jpg', 'caption': 'Pneumonia with Pseudomonas aeruginosa etiology. The high definition CT shows complex consolidated infectious infiltrations in 6 segments of both lungs and in the upper right lobe. Additinally, there are spread nodules congestions with mid-lobule and bronchi distribution and bronchail congestion in the 3rd segment of the left lung.', 'hash': '16c61687b5810393f56488cc861077043e270da28c64ec51d2642422f34d79f4'}] | {'poljradiol-77-3-64-g001': ['In patients after liver and kidney transplantation gram-negative bacteria are resposible for 90% and 69% of bacterial pneumonia respectively [5,10]. The group of gram-negative bacteria among others includes: Pseudomonas, Klebsiella, Eschericha, Acinetobacter and Enterobacter. Diversified radiological pneumonia imaging reflects this group’s complexity: starting with well separated nodules to the complex multifocal congestions with air bronchogram. The most frequent is this group is Pseudomonas aeruginosa responsible for approx. 60% of infections [5]. The infection with Pseudomonas takes place mainly as a result of aspiration in the upper airways and rarely through the blood stream regarding bacteremia. That is why, infection changes have the character of bronchopneumonia [11]. Radiological imaging presents dominating on both sides complex nodules with lower lobes predilection [12]. The changes in the lung parenchyma are very often accompanied by pleural effusion or pleural thickening. With the development of the disease, the nodules conglomerate and form complex lung parenchyma with air bronchogram [12] (<xref ref-type="fig" rid="poljradiol-77-3-64-g001">Figure 1</xref>). In ). In Pseudomonas infection absces in lung parynchema often occur. They are visible in the chest X-rays and have the form of circle infectious infiltrations with the bright interval meaning destruction of lung tissue [12]. Central bright interval may transform into a cavity with thick walls and liquid inside. Another gram-negative bacteria very often causing pneumonia among transplant recipients is Klebsiella pneumoniae. It is responsible for lobe pneumonia similar in symptoms to pneumoccocus infection however, in case of Klebisiella, the infected lobe has bigger size which results in higher visibility of the interlobe spaces [13] (<xref ref-type="fig" rid="poljradiol-77-3-64-g002">Figure 2</xref>). Absceses and effusions in the peural cavity occur more often than in ). Absceses and effusions in the peural cavity occur more often than in pneumoccocus pneumonia [13].', 'Cytomegalovirus pneumonia is a frequent complication during the first 6 months after transplantation. Cytomegalovirus is responsible for approx. 56% of lung infections among patients with transplanted lungs and 47% of pneumonia in patients after liver transplantations [10,14]. Pneumonia caused by CMV can occur in approx. 2% of kidneys’ recipients [5]. High definition chest CT shows small spread nodule places located in the central part of lobule and the shading areas of ‘dim glass’ which in case of some patients may develop in the direction of parenchyma congestions [19] (<xref ref-type="fig" rid="poljradiol-77-3-64-g001">Figure 4</xref>). Rather rarely the alveolar congestions constitute initial changes. Thickening of the bronchial walls or a tree-in bud symptom occur rather rarely [). Rather rarely the alveolar congestions constitute initial changes. Thickening of the bronchial walls or a tree-in bud symptom occur rather rarely [19].'], 'poljradiol-77-3-64-g003': ['MTBs are respnsible for approx. 2% to 5% of pneumonia cases among patients with lungs and heart transplants and for approx.20% of pneumonia cases among kidneys’ recipients [5,14,15]. The patients undergoing long-term immunosuppression have increased risk of reactivation of diseases they had before. They are also prone to the initial infection. The radiological imaging of TB among patients after transplantation is not characteristic. The spectrum of changes is very wide and includes separate nodules in lung parenchyma, complex nodules, complex lobe parenchyma changes, fibrocavitary changes in the upper parts of lungs, enlargement of lymph glands in mediastinum and effusion in pleural cavity [16] (<xref ref-type="fig" rid="poljradiol-77-3-64-g003">Figure 3A, B</xref>). The only change that statistically more often occurs in lungs’ TB than in other bacterial infections is tree-in bud symptom [). The only change that statistically more often occurs in lungs’ TB than in other bacterial infections is tree-in bud symptom [17] (<xref ref-type="fig" rid="poljradiol-77-3-64-g003">Figure 3C</xref>). It is visible in high definition CT and results from the infectious effusion of bronchial walls. It occurs in active TB and patient’s contagiousness. In patients treated with small doses of immunusuppresive medicines, the radiological imaging may be similar to the initial TB of patients with normal immunity so the congestions may appear in the upper and back part of the upper lobe or the upper part of the bottom lobe with the possibility of cavity development [). It is visible in high definition CT and results from the infectious effusion of bronchial walls. It occurs in active TB and patient’s contagiousness. In patients treated with small doses of immunusuppresive medicines, the radiological imaging may be similar to the initial TB of patients with normal immunity so the congestions may appear in the upper and back part of the upper lobe or the upper part of the bottom lobe with the possibility of cavity development [18]. The deeper immunosuppresion, the more frequent lobe’s parenchyma congestions (caseous pneumonia), miliary changes taking form of small nodules (TB spread through the blood) and enlargement of the lymph glands of mediastinum and spaces in lungs including central necrosis and increased contrast [18] (<xref ref-type="fig" rid="poljradiol-77-3-64-g003">Figure 3D</xref>). Evaluation of the activity regarding TB changes is a frequent clinical question. The changes indicating activity of the disease are parenchyma congestions, tree-in bud symptom, miliary changes and cavities [). Evaluation of the activity regarding TB changes is a frequent clinical question. The changes indicating activity of the disease are parenchyma congestions, tree-in bud symptom, miliary changes and cavities [16]. Linear congestions, calcified nodules and bronchiectasia are inactive modifications [16] (Table 3). However, the evaluation of the disease’s activity should be based on the conducted tests and stated lack of dynamics regarding radiological imaging within 6 months minimum [16].'], 'poljradiol-77-3-64-g005': ['Flu wirus is a frequent cause of the upper air passages infections among immunocompetent persons. In patients udergoing immunosuppresive treatment it also may cause pneumonia. However, it is not the only pathogen responsible for the lungs infection as very often the etiology is rather mixed. Microorganisms which are most frequently isolated from the patients after lungs transplantations together with the flu virus are CMV and Pseudomonas aeruginosa [20] (<xref ref-type="fig" rid="poljradiol-77-3-64-g005">Figure 5</xref>). Due to the overlapping of changes caused by different infectious factors in the radiological imaging, it is difficult to define characteristic features of flu pneumonia. In most of the cases with the microbiologically confirmed pneumonia flu etiology, the chest X-rays present spread bilateral parenchyma congestions and small not well separated nodules [). Due to the overlapping of changes caused by different infectious factors in the radiological imaging, it is difficult to define characteristic features of flu pneumonia. In most of the cases with the microbiologically confirmed pneumonia flu etiology, the chest X-rays present spread bilateral parenchyma congestions and small not well separated nodules [21]. High definition chest CTs of these patients present shadings taking form of ‘dim glass’ with the nodules of 2–9 mm located in the central part of lobule, minor areas of alveolar congestions and a tree-in bud symptom [21] (<xref ref-type="fig" rid="poljradiol-77-3-64-g005">Figure 5</xref>).).'], 'poljradiol-77-3-64-g006': ['Aspergillus is isolated in approx. 13% of patients with pulmonary infections after lungs transplantations, 12% after heart transplantations, 9% after kidney transplantations and 3% after liver transplantations [5,10,14,15]. Aspergillus in the pulmonary area is responsible for a few diseases which develop depending on the immunological conditions of the patients. In patients with the normal immunity, it can cause saprophagan aspergilosis – aspergilloma or allergic broncho-pulmonary aspergillosis (ABPA) [22]. The patients with minor defects of immunity suffer from necrotic aspergillosis (half-invasive) [22]. Invasive aspergillosis – the form overtaking vessels, bronchi and the lungs parenchyma concerns patients with the serious immunity decrease. The invasive form of aspergillosis with infected bronchi and lungs parenchyma visible in CT includes dominating spread mid-lobule nodules which together with the line shading constitute a tree-in bud image[22]. They are accompanied by the bronchial parenchyma congestions and thickening of bronchial walls. The angi-invasive form concerns only patients with a seriuos defections of immunity i.e. patients undergoing treatments with the high amount of immunosuppresive medicines. The most characteristic change of this form of aspergillosis is halo sign present at the first stage of the disease even in 96% of patients [23] (<xref ref-type="fig" rid="poljradiol-77-3-64-g006">Figure 6A</xref>). This symptom visible in CT refelcts blocking of small vessels by fungus and microcollapses in the lungs parenchyma. This symptom also includes nodules and masses surrounded by the ‘dim glass’ shadings. The nodules present places of collapsing and shadings reflect alveloar bleeding. Although the symptom is also described in other diseases (among others in Wegener’s Granulomatosis, shifts of multivessel tumours, lung form of Kaposi tumour or infection of other etiology) in patients with infections resistant to the standard antibiotic therapy, it is considered to constitute the initial stage of angio-invasive aspergillosis [). This symptom visible in CT refelcts blocking of small vessels by fungus and microcollapses in the lungs parenchyma. This symptom also includes nodules and masses surrounded by the ‘dim glass’ shadings. The nodules present places of collapsing and shadings reflect alveloar bleeding. Although the symptom is also described in other diseases (among others in Wegener’s Granulomatosis, shifts of multivessel tumours, lung form of Kaposi tumour or infection of other etiology) in patients with infections resistant to the standard antibiotic therapy, it is considered to constitute the initial stage of angio-invasive aspergillosis [23]. When the patient’s immunity improves (decrease of immunosuppressive medicnes doses) and implementation of antifungal treatment, the separation of necrotic part of the lung from the surrounding parenchyma takes place and in the radiological imaging it is shown as air edging (<xref ref-type="fig" rid="poljradiol-77-3-64-g006">Figure 6B</xref>) [) [24].'], 'poljradiol-77-3-64-g007': ['Pneumocystis pneumonia occurs in 13% of patients after lungs transplantation, 6% after liver transplantation and 4% after kidney transplantation [5,10,14]. The chest imaging typically shows in this case bilateral internal linear changes in parenchyma which within a few days undergo development to alveolar congestions [25], (<xref ref-type="fig" rid="poljradiol-77-3-64-g007">Figure 7A</xref>). In 10–39% of patients the chest imaging may be correct and in another 5% the radiological imaging may be different and may include: isolated area of parenchyma congestions (mainly in upper lobes), spread nodules and cystic changes [). In 10–39% of patients the chest imaging may be correct and in another 5% the radiological imaging may be different and may include: isolated area of parenchyma congestions (mainly in upper lobes), spread nodules and cystic changes [25]. X-rays of 6% of patients show edema. In the high definition chest CT one can notice dominating bilateral internal shadings so-called ‘dim glass’ (present in 90% of patients [25]. 33% of patients have visible cystic changes in lung parenchyma, predilections to the upper lung lobes (<xref ref-type="fig" rid="poljradiol-77-3-64-g007">Figure 7B</xref>). Cystic changes with thin or thick walls have tendency to consolidating and if their location is underpleural, they constitute a risk of edema [). Cystic changes with thin or thick walls have tendency to consolidating and if their location is underpleural, they constitute a risk of edema [25]. Edema fluid and enlargement of the mediastinum lymph glands occur very rarely in case of pneumocystic pneumonia and should suggest other disease recognitions'], 'poljradiol-77-3-64-g008': ['Candida albicans is another blastomyces responsible for pneumonia in patients undergoing immunosuppression. It is most frequently isolated in patients after lungs transplantation, as it colonizes necrotic areas of lungs parenchyma [26]. The changes visible in the chest imaging are non-specific and include segmental or lobe parenchyma congestions [26]. The high definition chest CT shows in most of the cases bilateral, well separated nodules mainly in the lower lung lobes [26] [<xref ref-type="fig" rid="poljradiol-77-3-64-g008">Figure 8</xref>]. They may also be accompanied by other changes: mainly parenchyma congestions and shadings, less frequent are tree-in bud symptom and thickening of bronchial walls []. They may also be accompanied by other changes: mainly parenchyma congestions and shadings, less frequent are tree-in bud symptom and thickening of bronchial walls [26]. Rarely in the cases of lungs cadidiasis halo sign or nodules occur.']} | Radiological spectrum of pulmonary infections in patients post solid organ transplantation | [
"pneumonia",
"transplantation",
"imaging"
] | Pol J Radiol | 1341126000 | Pneumonia remains an important source of morbidity and mortality in transplant recipients. Since clinical findings are nonspecific and cultures may be time-consuming, imaging plays an important role in establishing the probable etiology of pneumonia. Plain films are used as an initial study. However, they have a limited capacity in differentiating the causative factors. HRCT is used as a problem-solving tool in patients with unclear plain film findings and/or no response to treatment. The main advantage of HRCT is a very detailed depiction of the lung parenchyma. Even though HRCT findings are not always specific, there are several sings that are more common in certain types of pneumonia. The aim of the article is to present radiological findings suggestive of a particular causative microorganism and show how they can narrow the differential diagnosis when coupled with clinical data. | [] | other | PMC3447437 | null | 26 | [
"{'Citation': 'Bulletins of Poltransplant dated 2000–2010'}",
"{'Citation': 'Bulletins of Poltransplant dated 2010'}",
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"{'Citation': 'Matar LD, McAdams HP, Palmer SM, et al. Respiratory Viral Infections in Lung Transplant Recipients: Radiologic Findings with Clinical Correlation. Radiology. 1999;213:735–42.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10580947'}}}",
"{'Citation': 'Oikonomou A, Müller NL, Nantel S. Radiographic and High-Resolution CT findings of influenza virus pneumonia in patients with hematologic malignancies. Am J Roentgenol. 2003;181:507–11.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12876036'}}}",
"{'Citation': 'Franquet T, Müller NL, Giménez A. Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics. 2001;21:825–37.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '11452056'}}}",
"{'Citation': 'Pinto PS. The CT halo sign. Radiology. 2004;230:109–10.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14695389'}}}",
"{'Citation': 'Curtis Amc B, Walker Smith GJ, Ravin CE. Air Crescent Sign of Invasive Aspergillosis. Radiology. 1979;133:17–21.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '472287'}}}",
"{'Citation': 'Crans CA, Jr, Boiselle PM. Imaging features of Pneumocystis carinii pneumonia. Crit Rev Diagn Imaging. 1999;40:251–84.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10514937'}}}",
"{'Citation': 'Solé A, Salavert M. Fungal infections after lung transplantation. Curr Opin Pulm Med. 2009;15:243–53.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '19305348'}}}"
] | Pol J Radiol. 2012 Jul-Sep; 77(3):64-70 | NO-CC CODE |
|
CT images of the patient. The position of right inferior dental canal can be seen clearly as a dark area but left inferior dental canal cannot be seen due to the impacted second premolar. (A; Right Mandibular Canal, B; Left Mandibular Canal, C; Tipped Right First Molar, D; Impacted Right Second | a10-fig4d | 7 | fd8d1631713ef371b69ec2f490510fca6379e8db87054d20168f61e18f8c92fa | a10-fig4d.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
745,
945
] | [{'image_id': 'a10-fig4b', 'image_file_name': 'a10-fig4b.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig4b.jpg', 'caption': 'CT images of the patient. The position of right inferior dental canal can be seen clearly as a dark area but left inferior dental canal cannot be seen due to the impacted second premolar. (A; Right Mandibular Canal, B; Left Mandibular Canal, C; Tipped Right First Molar, D; Impacted Right Second', 'hash': '12f347fe7b669a006f846a79c2c03cdb0978a303db5f1ef1a04d19089edc4a0b'}, {'image_id': 'a10-fig1', 'image_file_name': 'a10-fig1.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig1.jpg', 'caption': 'Intraoral view of the patient. Note that only a small cusp of right mandibular 1st molar can be seen.', 'hash': '7e6fbc07a4a3924c38097f1a801760fcaf2117f233e00dbc37af7f0859091ddf'}, {'image_id': 'a10-fig4d', 'image_file_name': 'a10-fig4d.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig4d.jpg', 'caption': 'CT images of the patient. The position of right inferior dental canal can be seen clearly as a dark area but left inferior dental canal cannot be seen due to the impacted second premolar. (A; Right Mandibular Canal, B; Left Mandibular Canal, C; Tipped Right First Molar, D; Impacted Right Second', 'hash': 'fd8d1631713ef371b69ec2f490510fca6379e8db87054d20168f61e18f8c92fa'}, {'image_id': 'a10-fig4c', 'image_file_name': 'a10-fig4c.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig4c.jpg', 'caption': 'CT images of the patient. The position of right inferior dental canal can be seen clearly as a dark area but left inferior dental canal cannot be seen due to the impacted second premolar. (A; Right Mandibular Canal, B; Left Mandibular Canal, C; Tipped Right First Molar, D; Impacted Right Second', 'hash': '097eeead4127bcf2fcce84408fef03d9a28741ca53f66844f84e9b27aaa5e436'}, {'image_id': 'a10-fig3', 'image_file_name': 'a10-fig3.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig3.jpg', 'caption': 'Occlusal radiography of the patient.', 'hash': '68fcbd6cf6b002b97cda57c6a0bab4e2ac98b2a74ab9d347cd51e93acf8b39cc'}, {'image_id': 'a10-fig4a', 'image_file_name': 'a10-fig4a.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig4a.jpg', 'caption': 'CT images of the patient. The position of right inferior dental canal can be seen clearly as a dark area but left inferior dental canal cannot be seen due to the impacted second premolar. (A; Right Mandibular Canal, B; Left Mandibular Canal, C; Tipped Right First Molar, D; Impacted Right Second', 'hash': '2dcbbbf1048f876cabb02fad7660973ff71a0bca9ea10326e22487b7bc29f31f'}, {'image_id': 'a10-fig2', 'image_file_name': 'a10-fig2.jpg', 'image_path': '../data/media_files/PMC2609912/a10-fig2.jpg', 'caption': 'Panoramic radiography of the patient.', 'hash': 'a3fb0d528d405a3f4ffde02b91d0a2c92d6ba6008f5194227d04add95f20cb0e'}] | {'a10-fig1': ['Seventeen years-old Caucasian girl was presented to the clinics of the Department of Pedodontics, Faculty of Dentistry, Süleyman Demirel University for routine dental inspection. The medical history of the patient was insignificant. Clinical examination showed normal development of the dentition except for missing mandibular, right permanent second premolar and first molar. No sign of swelling, redness or discomfort was noted in the region. Only a small cusp of a tooth can be seen inside the gingiva (<xref ref-type="fig" rid="a10-fig1">Figure 1</xref>).).'], 'a10-fig2': ['Subsequent radiographic examination revealed an ankylosed second primary molar which caused impaction of the second premolar and tipping of the first molar. The second premolar which had a dilacerated root failed to erupt and was lying close to the lower border of the mandible (<xref ref-type="fig" rid="a10-fig2">Figures 2</xref> and and <xref ref-type="fig" rid="a10-fig3">3</xref>). The tooth appeared to be in close proximity to the inferior alveolar canal as clearly seen in panoramic radiograph (). The tooth appeared to be in close proximity to the inferior alveolar canal as clearly seen in panoramic radiograph (<xref ref-type="fig" rid="a10-fig2">Figure 2</xref>).).'], 'a10-fig4a': ['In order to assess the position of the inferior alveolar canal and the relationship between the canal and second premolar a coronal, CT was taken (Philips Tomoscan, Netherlands). CT scanning of the mandible consisted of 26 slices with a thickness of 3mm and 1mm slice gap. Relationship of inferior alveolar canal and impacted premolar can be observed in <xref ref-type="fig" rid="a10-fig4a">Figure 4</xref>. Furthermore the amount of bone volume of the involved section and symmetrical section (to compare the bone volume) calculated from the slices on post processing screen of the system. The bone volume was 8.46cm. Furthermore the amount of bone volume of the involved section and symmetrical section (to compare the bone volume) calculated from the slices on post processing screen of the system. The bone volume was 8.46cm3 on the right side compared to 12.75cm3 on the opposing side which demonstrated that the structural weakness could arise, if molar, premolar and primary second molar were extracted. This could lead to long term problems such as potential pathological fracture of the mandible.']} | Value of Computed Tomography (CT) in Imaging the Morbidity of Submerged Molars: A Case Report | [
"Submerged molars",
"Ankylosis",
"Impaction",
"Computed tomography"
] | Eur J Dent | 1191222000 | Submerged primary molars can be difficult to manage due to the developing dentition. Rarely in some severe cases, may the surgical interventions be required while ensuring the vital structures are protected. Therefore these cases require sophisticated imaging techniques in order to locate the vital structures.In this case report, a 17 year old girl who had a retained and submerged deciduous molar which caused impaction of the second premolar and tipping of the first molar was presented. In addition, value of computed tomography (CT) for locating the vital anatomic structures was discussed.In our case, CT has been supplied effective information about localization of the vital structures and amount of bone volume during the diagnosis and treatment planning period in addition to the routine dental radiographies. | [] | other | PMC2609912 | null | 23 | [
"{'Citation': 'Kitai N, Fujii Y, Murakami S, Takada K. Three-dimensional evaluation of rare case with multiple impacted teeth using CT. J Clin Pediatr Dent. 2003;27:117–121.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12597681'}}}",
"{'Citation': 'Chen H-S, Lieu J-D. An unusual primary first molar impaction associated with a supernumerary tooth. Case report. Aust Dent J. 1993;38:277–279.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8216034'}}}",
"{'Citation': 'Douglass J, Tinanoff N. The etiology, prevalence, and sequelae of infrooclusion of primary molars. J Dent Child. 1991;58:481–483.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1783699'}}}",
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"{'Citation': 'Nasel CJO, Pretterlieber M, Gahleitner A, et al. Osteometry of the mandible performed using dental MR imaging. Am J Neuroradiol. 1999;20:1221–1227.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC7055995'}, {'@IdType': 'pubmed', '#text': '10472975'}]}}",
"{'Citation': 'Freisfeld M, Dahl IA, Jager A, Dresher D, Schuller H. X-ray diagnosis of impacted upper canines in panoramic radiographs and computed tomographs. J Orofac Orthop. 1999;60:177–184.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '10394211'}}}",
"{'Citation': 'Preda L, La Fianza A, Di Maggio EM, et al. The use spiral computed tomography in the localization of impacted maxillary canines. Dentomaxillofac Radiol. 1997;26:236–241.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9442615'}}}",
"{'Citation': 'Krenmair G, Lenglinger FX, Traxler M. Imaging of unerupted and displaced teeth by cross-sectional CT scans. Int J Oral Maxillofac Surg. 1995;24:413–416.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '8636637'}}}",
"{'Citation': 'Schmuth GP, Freisfeld M, Koster O, Schuller H. The application of computerized tomography (CT) in cases of impacted maxillary canines. Eur J Orthod. 1992;14:296–301.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '1516662'}}}",
"{'Citation': 'Computed tomography. Wikipedia, The Free Encyclopedia. 2007. Sep 6, Retrieved 09:43, September 7,2007, from; http://en.wikipedia.org/w/index.php?title=Computed_tomography&oldid=156062111.'}",
"{'Citation': 'Frush DP, Donnelly LF, Rosen NS. Computed Tomography and Radiation Risks: What Pediatric Health Care Providers Should Know. Pediatrics. 2003;112:951–957.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '14523191'}}}",
"{'Citation': 'Schulze C. Developmental abnormalities of the teeth and jaws. In: Gorlin RJ, Goldman HM, editors. Thoma’s Oral Pathology. St. Louis: Mosby Company; 1970. pp. 152–53.'}",
"{'Citation': 'Ltyle JJ. Indications and contrindications for removal of the impacted tooth. Dent Clin North Am. 1979;23:333–336.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '381053'}}}",
"{'Citation': 'Altay N, Cengiz SB. Space-regaining treatment for a submerged primary molar: A case report. Int J Paediatr Dent. 2002;12:286–289.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '12121541'}}}",
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] | Eur J Dent. 2007 Oct; 1(4):246-250 | NO-CC CODE |
|
(A) Cervical magnetic resonance imaging (MRI) (T1-weighted): 10 months before the operation. Arrow points to the minimal structural and intensity change in odontoid process. (B) Cervical MRI (T2-weighted): 10 months before the operation. | 10-1055-s-0035-1550340-i1400085-1 | 7 | 17e7c8bc80ca4e41f14e23f16ea9da6162daec589d29cacd9b92cc4e357474bf | 10-1055-s-0035-1550340-i1400085-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
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"computerized tomography"
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800,
448
] | [{'image_id': '10-1055-s-0035-1550340-i1400085-8', 'image_file_name': '10-1055-s-0035-1550340-i1400085-8.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-8.jpg', 'caption': '(A) First operation, postoperative plain X-rays. (B) First operation, postoperative computed tomography scan. Arrow points to the remnant of the tumor in left part of spinal canal.', 'hash': '10feea2e9b4e30004a3dab7cbf85b77118f2079cc04dad0a52e5d7de2317ec82'}, {'image_id': '10-1055-s-0035-1550340-i1400085-1', 'image_file_name': '10-1055-s-0035-1550340-i1400085-1.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-1.jpg', 'caption': '(A) Cervical magnetic resonance imaging (MRI) (T1-weighted): 10 months before the operation. Arrow points to the minimal structural and intensity change in odontoid process. (B) Cervical MRI (T2-weighted): 10 months before the operation.', 'hash': '17e7c8bc80ca4e41f14e23f16ea9da6162daec589d29cacd9b92cc4e357474bf'}, {'image_id': '10-1055-s-0035-1550340-i1400085-6', 'image_file_name': '10-1055-s-0035-1550340-i1400085-6.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-6.jpg', 'caption': 'Multidetector computed tomography angiogram of neck and skull base: arrow shows right C2 segment vertebral artery occlusion.', 'hash': '37a2299d28615f94b9070585db302fc2c23acb96c59634f8b7a16bae4868cc66'}, {'image_id': '10-1055-s-0035-1550340-i1400085-11', 'image_file_name': '10-1055-s-0035-1550340-i1400085-11.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-11.jpg', 'caption': 'Excised mass hematoxylin and eosin histopathology.', 'hash': '3f99f6167ef6f066298a758ae3dd6faac4f28816c323b50df894f843c5b21962'}, {'image_id': '10-1055-s-0035-1550340-i1400085-7', 'image_file_name': '10-1055-s-0035-1550340-i1400085-7.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-7.jpg', 'caption': '(A) First operation: arrow points to the bony texture of posterior part of the tumor that required drilling. (B) First operation: final posterior fixation. Arrow shows posterior C1 arc.', 'hash': 'a38b780c953ece1066f71ce8cc8cd208dbfa73f0e6cd7f6bccb76303229972d5'}, {'image_id': '10-1055-s-0035-1550340-i1400085-9', 'image_file_name': '10-1055-s-0035-1550340-i1400085-9.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-9.jpg', 'caption': '(A) Second operation: arrow shows anterior arc of C1. (B) Second operation: implant fixed to C1 with sublaminar wiring technique.', 'hash': '674105e3705e542a97489f073cb598912dc3f6772399033e34a3858022405d14'}, {'image_id': '10-1055-s-0035-1550340-i1400085-10', 'image_file_name': '10-1055-s-0035-1550340-i1400085-10.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-10.jpg', 'caption': 'Second operation: postoperative X-ray.', 'hash': 'e4bddcd4adc5f3681ceb51b27649235c031266106898f4fa3e6918cdcf87beab'}, {'image_id': '10-1055-s-0035-1550340-i1400085-3', 'image_file_name': '10-1055-s-0035-1550340-i1400085-3.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-3.jpg', 'caption': '(A) Cervical computed tomography (CT), sagittal reformat: calcified mass of C2 that also affected C3. (B) Cervical CT, axial view: arrow points to the well demarcated calcified lesion involving body and right side posterior element of C2.', 'hash': '725f507c44995db4058525eba1fbce9e603aab198447b9465c9a8177b52928c9'}, {'image_id': '10-1055-s-0035-1550340-i1400085-4', 'image_file_name': '10-1055-s-0035-1550340-i1400085-4.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-4.jpg', 'caption': '(A) Cervical magnetic resonance imaging (MRI; T2-weighted): inhomogeneous mass extending from clivus to C4. (B) Cervical MRI (T1-weighted). (C) Cervical MRI (gadolinium-enhanced): enhancing mass destructed C2 and C3 vertebra.', 'hash': 'b0a3aa054b34e62c20b24265fb98486c2602244380380b13dd2e3bc70b2fbfd7'}, {'image_id': '10-1055-s-0035-1550340-i1400085-12', 'image_file_name': '10-1055-s-0035-1550340-i1400085-12.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-12.jpg', 'caption': '(A) Thirty-month follow-up plain X-ray. (B) Thirty-month follow-up plain X-ray (flexion view). (C) Thirty-month follow-up plain X-ray (extension view). (D) Two-year follow-up magnetic resonance imaging.', 'hash': '0ae43c6843909a1536f121859a4270f001b3fa6c441a517e1644cdaa7fac82de'}, {'image_id': '10-1055-s-0035-1550340-i1400085-5', 'image_file_name': '10-1055-s-0035-1550340-i1400085-5.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-5.jpg', 'caption': 'Cervical magnetic resonance imaging (axial images): arrow shows the right vertebral artery that is encompassed by the mass.', 'hash': '05bddc4aced8118b83d9f1f2a698d75f04db62e8cb95a6a0cbe08329e705ab62'}, {'image_id': '10-1055-s-0035-1550340-i1400085-2', 'image_file_name': '10-1055-s-0035-1550340-i1400085-2.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-2.jpg', 'caption': 'Cervical X-ray: Arrows show the erosion of vertebral body and posterior elements of C2–C3 by the expansile mass.', 'hash': '1b94d0826b8f899f3e978e119a1b34358227a38b64faf53626c0d9e7ee2156ee'}] | {'10-1055-s-0035-1550340-i1400085-1': ['A 6-year-old boy was referred to our department by a neurosurgeon for a newly developed neck skew and aggravation of neck pain that had been bothering the patient for 2 years. Prior to his visit at our department, he was under a 2-year follow-up by several pediatricians for neck pain and pain on neck motion. Magnetic resonance imaging (MRI) was obtained at that time but did not show a significant finding (<xref rid="10-1055-s-0035-1550340-i1400085-1" ref-type="fig">Fig. 1A, B</xref>). When we visited the patient, in addition to neck skew and pain, he complained of difficulty swallowing. Neck pain worsened at night with no significant response to aspirin. His past medical history and family history for malignancy was unremarkable.). When we visited the patient, in addition to neck skew and pain, he complained of difficulty swallowing. Neck pain worsened at night with no significant response to aspirin. His past medical history and family history for malignancy was unremarkable.'], '10-1055-s-0035-1550340-i1400085-2': ['Chest X-ray was unremarkable. Cervical X-ray (<xref rid="10-1055-s-0035-1550340-i1400085-2" ref-type="fig">Fig. 2</xref>) revealed an expansile lesion that eroded the vertebral body and posterior elements of C2–C3. Spiral axial computed tomography (CT) scan of the cervical column () revealed an expansile lesion that eroded the vertebral body and posterior elements of C2–C3. Spiral axial computed tomography (CT) scan of the cervical column (<xref rid="10-1055-s-0035-1550340-i1400085-3" ref-type="fig">Fig. 3A, B</xref>) depicted a large 36\u2009×\u200933\u2009×\u200927-mm calcified mass of C2 that caused deformity of C2 and also affected C3 with severe pressure erosion of the odontoid process. Secondary spinal canal narrowing was also noted (anteroposterior canal diameter: 8 mm). MRI () depicted a large 36\u2009×\u200933\u2009×\u200927-mm calcified mass of C2 that caused deformity of C2 and also affected C3 with severe pressure erosion of the odontoid process. Secondary spinal canal narrowing was also noted (anteroposterior canal diameter: 8 mm). MRI (<xref rid="10-1055-s-0035-1550340-i1400085-4" ref-type="fig">Fig. 4A, B</xref>) revealed an expansile, well-demarcated, inhomogeneous (iso- and hypointense in T1-weighted images and hypo- and hyperintense in T2-weighted images) mass that extended from the clivus to C4. Gadolinium-enhanced images () revealed an expansile, well-demarcated, inhomogeneous (iso- and hypointense in T1-weighted images and hypo- and hyperintense in T2-weighted images) mass that extended from the clivus to C4. Gadolinium-enhanced images (<xref rid="10-1055-s-0035-1550340-i1400085-4" ref-type="fig">Fig. 4C</xref>) depicted destruction of the C2 and C3 vertebra (the odontoid process, right facet joints, and both vertebral bodies). Axial MRIs displayed encircling of right vertebral artery () depicted destruction of the C2 and C3 vertebra (the odontoid process, right facet joints, and both vertebral bodies). Axial MRIs displayed encircling of right vertebral artery (<xref rid="10-1055-s-0035-1550340-i1400085-5" ref-type="fig">Fig. 5</xref>).).'], '10-1055-s-0035-1550340-i1400085-6': ['Multidetector CT angiogram of the neck and skull base (<xref rid="10-1055-s-0035-1550340-i1400085-6" ref-type="fig">Fig. 6</xref>) showed right vertebral artery lateral displacement by a huge C2 lobulated mass that was abutting the right vertebral artery. Whole-body bone scan by Tc-99m-methylene diphosphonate was also performed, which showed an abnormally increased uptake of radioactive uptake in C2. Results of CT-guided C2 needle biopsy were highly suggestive of osteoblastoma.) showed right vertebral artery lateral displacement by a huge C2 lobulated mass that was abutting the right vertebral artery. Whole-body bone scan by Tc-99m-methylene diphosphonate was also performed, which showed an abnormally increased uptake of radioactive uptake in C2. Results of CT-guided C2 needle biopsy were highly suggestive of osteoblastoma.'], '10-1055-s-0035-1550340-i1400085-7': ['The patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of the C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. The posterior fixation of C1–C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Intraoperative images are shown in <xref rid="10-1055-s-0035-1550340-i1400085-7" ref-type="fig">Fig. 7</xref>. . <xref rid="10-1055-s-0035-1550340-i1400085-8" ref-type="fig">Fig. 8A, B</xref> shows X-ray and CT after the first operation. After 10 days, total resection of residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath; shows X-ray and CT after the first operation. After 10 days, total resection of residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath; <xref rid="10-1055-s-0035-1550340-i1400085-9" ref-type="fig">Fig. 9A, B</xref>). The vertebral artery was obliterated. Due to a thin C1 arch and the absence of good bony purchase for screws, we used anterior sublaminar wiring for C1 and reconstructed the C2–C3 bodies with an expandable cage. The lower end of the implant was screwed to C4. ). The vertebral artery was obliterated. Due to a thin C1 arch and the absence of good bony purchase for screws, we used anterior sublaminar wiring for C1 and reconstructed the C2–C3 bodies with an expandable cage. The lower end of the implant was screwed to C4. <xref rid="10-1055-s-0035-1550340-i1400085-10" ref-type="fig">Fig. 10</xref> displays the X-ray after the second operation. displays the X-ray after the second operation.'], '10-1055-s-0035-1550340-i1400085-11': ['The pathologic examination (<xref rid="10-1055-s-0035-1550340-i1400085-11" ref-type="fig">Fig. 11</xref>) showed osteoblasts suggestive of osteoblastoma.) showed osteoblasts suggestive of osteoblastoma.'], '10-1055-s-0035-1550340-i1400085-12': ['\n<xref rid="10-1055-s-0035-1550340-i1400085-12" ref-type="fig">Fig. 12A, B, C</xref> demonstrates plain X-rays. demonstrates plain X-rays. <xref rid="10-1055-s-0035-1550340-i1400085-12" ref-type="fig">Fig. 12D</xref> shows MRI taken at 2-year follow-up. No tumor recurrence or instability is noted. shows MRI taken at 2-year follow-up. No tumor recurrence or instability is noted.']} | Anterior Reconstruction of C2–C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique | [
"anterior C1 sublaminar wiring",
"cervical",
"osteoblastoma",
"pediatric spine"
] | Global Spine J | 1454745600 | Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1-C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1-C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2-C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2-C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies. | [] | other | PMC4733373 | null | 36 | [
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] | Global Spine J. 2016 Feb 6; 6(1):e21-e29 | NO-CC CODE |
|
(A) Cervical magnetic resonance imaging (MRI; T2-weighted): inhomogeneous mass extending from clivus to C4. (B) Cervical MRI (T1-weighted). (C) Cervical MRI (gadolinium-enhanced): enhancing mass destructed C2 and C3 vertebra. | 10-1055-s-0035-1550340-i1400085-4 | 7 | b0a3aa054b34e62c20b24265fb98486c2602244380380b13dd2e3bc70b2fbfd7 | 10-1055-s-0035-1550340-i1400085-4.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
335
] | [{'image_id': '10-1055-s-0035-1550340-i1400085-8', 'image_file_name': '10-1055-s-0035-1550340-i1400085-8.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-8.jpg', 'caption': '(A) First operation, postoperative plain X-rays. (B) First operation, postoperative computed tomography scan. Arrow points to the remnant of the tumor in left part of spinal canal.', 'hash': '10feea2e9b4e30004a3dab7cbf85b77118f2079cc04dad0a52e5d7de2317ec82'}, {'image_id': '10-1055-s-0035-1550340-i1400085-1', 'image_file_name': '10-1055-s-0035-1550340-i1400085-1.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-1.jpg', 'caption': '(A) Cervical magnetic resonance imaging (MRI) (T1-weighted): 10 months before the operation. Arrow points to the minimal structural and intensity change in odontoid process. (B) Cervical MRI (T2-weighted): 10 months before the operation.', 'hash': '17e7c8bc80ca4e41f14e23f16ea9da6162daec589d29cacd9b92cc4e357474bf'}, {'image_id': '10-1055-s-0035-1550340-i1400085-6', 'image_file_name': '10-1055-s-0035-1550340-i1400085-6.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-6.jpg', 'caption': 'Multidetector computed tomography angiogram of neck and skull base: arrow shows right C2 segment vertebral artery occlusion.', 'hash': '37a2299d28615f94b9070585db302fc2c23acb96c59634f8b7a16bae4868cc66'}, {'image_id': '10-1055-s-0035-1550340-i1400085-11', 'image_file_name': '10-1055-s-0035-1550340-i1400085-11.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-11.jpg', 'caption': 'Excised mass hematoxylin and eosin histopathology.', 'hash': '3f99f6167ef6f066298a758ae3dd6faac4f28816c323b50df894f843c5b21962'}, {'image_id': '10-1055-s-0035-1550340-i1400085-7', 'image_file_name': '10-1055-s-0035-1550340-i1400085-7.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-7.jpg', 'caption': '(A) First operation: arrow points to the bony texture of posterior part of the tumor that required drilling. (B) First operation: final posterior fixation. Arrow shows posterior C1 arc.', 'hash': 'a38b780c953ece1066f71ce8cc8cd208dbfa73f0e6cd7f6bccb76303229972d5'}, {'image_id': '10-1055-s-0035-1550340-i1400085-9', 'image_file_name': '10-1055-s-0035-1550340-i1400085-9.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-9.jpg', 'caption': '(A) Second operation: arrow shows anterior arc of C1. (B) Second operation: implant fixed to C1 with sublaminar wiring technique.', 'hash': '674105e3705e542a97489f073cb598912dc3f6772399033e34a3858022405d14'}, {'image_id': '10-1055-s-0035-1550340-i1400085-10', 'image_file_name': '10-1055-s-0035-1550340-i1400085-10.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-10.jpg', 'caption': 'Second operation: postoperative X-ray.', 'hash': 'e4bddcd4adc5f3681ceb51b27649235c031266106898f4fa3e6918cdcf87beab'}, {'image_id': '10-1055-s-0035-1550340-i1400085-3', 'image_file_name': '10-1055-s-0035-1550340-i1400085-3.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-3.jpg', 'caption': '(A) Cervical computed tomography (CT), sagittal reformat: calcified mass of C2 that also affected C3. (B) Cervical CT, axial view: arrow points to the well demarcated calcified lesion involving body and right side posterior element of C2.', 'hash': '725f507c44995db4058525eba1fbce9e603aab198447b9465c9a8177b52928c9'}, {'image_id': '10-1055-s-0035-1550340-i1400085-4', 'image_file_name': '10-1055-s-0035-1550340-i1400085-4.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-4.jpg', 'caption': '(A) Cervical magnetic resonance imaging (MRI; T2-weighted): inhomogeneous mass extending from clivus to C4. (B) Cervical MRI (T1-weighted). (C) Cervical MRI (gadolinium-enhanced): enhancing mass destructed C2 and C3 vertebra.', 'hash': 'b0a3aa054b34e62c20b24265fb98486c2602244380380b13dd2e3bc70b2fbfd7'}, {'image_id': '10-1055-s-0035-1550340-i1400085-12', 'image_file_name': '10-1055-s-0035-1550340-i1400085-12.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-12.jpg', 'caption': '(A) Thirty-month follow-up plain X-ray. (B) Thirty-month follow-up plain X-ray (flexion view). (C) Thirty-month follow-up plain X-ray (extension view). (D) Two-year follow-up magnetic resonance imaging.', 'hash': '0ae43c6843909a1536f121859a4270f001b3fa6c441a517e1644cdaa7fac82de'}, {'image_id': '10-1055-s-0035-1550340-i1400085-5', 'image_file_name': '10-1055-s-0035-1550340-i1400085-5.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-5.jpg', 'caption': 'Cervical magnetic resonance imaging (axial images): arrow shows the right vertebral artery that is encompassed by the mass.', 'hash': '05bddc4aced8118b83d9f1f2a698d75f04db62e8cb95a6a0cbe08329e705ab62'}, {'image_id': '10-1055-s-0035-1550340-i1400085-2', 'image_file_name': '10-1055-s-0035-1550340-i1400085-2.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-2.jpg', 'caption': 'Cervical X-ray: Arrows show the erosion of vertebral body and posterior elements of C2–C3 by the expansile mass.', 'hash': '1b94d0826b8f899f3e978e119a1b34358227a38b64faf53626c0d9e7ee2156ee'}] | {'10-1055-s-0035-1550340-i1400085-1': ['A 6-year-old boy was referred to our department by a neurosurgeon for a newly developed neck skew and aggravation of neck pain that had been bothering the patient for 2 years. Prior to his visit at our department, he was under a 2-year follow-up by several pediatricians for neck pain and pain on neck motion. Magnetic resonance imaging (MRI) was obtained at that time but did not show a significant finding (<xref rid="10-1055-s-0035-1550340-i1400085-1" ref-type="fig">Fig. 1A, B</xref>). When we visited the patient, in addition to neck skew and pain, he complained of difficulty swallowing. Neck pain worsened at night with no significant response to aspirin. His past medical history and family history for malignancy was unremarkable.). When we visited the patient, in addition to neck skew and pain, he complained of difficulty swallowing. Neck pain worsened at night with no significant response to aspirin. His past medical history and family history for malignancy was unremarkable.'], '10-1055-s-0035-1550340-i1400085-2': ['Chest X-ray was unremarkable. Cervical X-ray (<xref rid="10-1055-s-0035-1550340-i1400085-2" ref-type="fig">Fig. 2</xref>) revealed an expansile lesion that eroded the vertebral body and posterior elements of C2–C3. Spiral axial computed tomography (CT) scan of the cervical column () revealed an expansile lesion that eroded the vertebral body and posterior elements of C2–C3. Spiral axial computed tomography (CT) scan of the cervical column (<xref rid="10-1055-s-0035-1550340-i1400085-3" ref-type="fig">Fig. 3A, B</xref>) depicted a large 36\u2009×\u200933\u2009×\u200927-mm calcified mass of C2 that caused deformity of C2 and also affected C3 with severe pressure erosion of the odontoid process. Secondary spinal canal narrowing was also noted (anteroposterior canal diameter: 8 mm). MRI () depicted a large 36\u2009×\u200933\u2009×\u200927-mm calcified mass of C2 that caused deformity of C2 and also affected C3 with severe pressure erosion of the odontoid process. Secondary spinal canal narrowing was also noted (anteroposterior canal diameter: 8 mm). MRI (<xref rid="10-1055-s-0035-1550340-i1400085-4" ref-type="fig">Fig. 4A, B</xref>) revealed an expansile, well-demarcated, inhomogeneous (iso- and hypointense in T1-weighted images and hypo- and hyperintense in T2-weighted images) mass that extended from the clivus to C4. Gadolinium-enhanced images () revealed an expansile, well-demarcated, inhomogeneous (iso- and hypointense in T1-weighted images and hypo- and hyperintense in T2-weighted images) mass that extended from the clivus to C4. Gadolinium-enhanced images (<xref rid="10-1055-s-0035-1550340-i1400085-4" ref-type="fig">Fig. 4C</xref>) depicted destruction of the C2 and C3 vertebra (the odontoid process, right facet joints, and both vertebral bodies). Axial MRIs displayed encircling of right vertebral artery () depicted destruction of the C2 and C3 vertebra (the odontoid process, right facet joints, and both vertebral bodies). Axial MRIs displayed encircling of right vertebral artery (<xref rid="10-1055-s-0035-1550340-i1400085-5" ref-type="fig">Fig. 5</xref>).).'], '10-1055-s-0035-1550340-i1400085-6': ['Multidetector CT angiogram of the neck and skull base (<xref rid="10-1055-s-0035-1550340-i1400085-6" ref-type="fig">Fig. 6</xref>) showed right vertebral artery lateral displacement by a huge C2 lobulated mass that was abutting the right vertebral artery. Whole-body bone scan by Tc-99m-methylene diphosphonate was also performed, which showed an abnormally increased uptake of radioactive uptake in C2. Results of CT-guided C2 needle biopsy were highly suggestive of osteoblastoma.) showed right vertebral artery lateral displacement by a huge C2 lobulated mass that was abutting the right vertebral artery. Whole-body bone scan by Tc-99m-methylene diphosphonate was also performed, which showed an abnormally increased uptake of radioactive uptake in C2. Results of CT-guided C2 needle biopsy were highly suggestive of osteoblastoma.'], '10-1055-s-0035-1550340-i1400085-7': ['The patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of the C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. The posterior fixation of C1–C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Intraoperative images are shown in <xref rid="10-1055-s-0035-1550340-i1400085-7" ref-type="fig">Fig. 7</xref>. . <xref rid="10-1055-s-0035-1550340-i1400085-8" ref-type="fig">Fig. 8A, B</xref> shows X-ray and CT after the first operation. After 10 days, total resection of residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath; shows X-ray and CT after the first operation. After 10 days, total resection of residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath; <xref rid="10-1055-s-0035-1550340-i1400085-9" ref-type="fig">Fig. 9A, B</xref>). The vertebral artery was obliterated. Due to a thin C1 arch and the absence of good bony purchase for screws, we used anterior sublaminar wiring for C1 and reconstructed the C2–C3 bodies with an expandable cage. The lower end of the implant was screwed to C4. ). The vertebral artery was obliterated. Due to a thin C1 arch and the absence of good bony purchase for screws, we used anterior sublaminar wiring for C1 and reconstructed the C2–C3 bodies with an expandable cage. The lower end of the implant was screwed to C4. <xref rid="10-1055-s-0035-1550340-i1400085-10" ref-type="fig">Fig. 10</xref> displays the X-ray after the second operation. displays the X-ray after the second operation.'], '10-1055-s-0035-1550340-i1400085-11': ['The pathologic examination (<xref rid="10-1055-s-0035-1550340-i1400085-11" ref-type="fig">Fig. 11</xref>) showed osteoblasts suggestive of osteoblastoma.) showed osteoblasts suggestive of osteoblastoma.'], '10-1055-s-0035-1550340-i1400085-12': ['\n<xref rid="10-1055-s-0035-1550340-i1400085-12" ref-type="fig">Fig. 12A, B, C</xref> demonstrates plain X-rays. demonstrates plain X-rays. <xref rid="10-1055-s-0035-1550340-i1400085-12" ref-type="fig">Fig. 12D</xref> shows MRI taken at 2-year follow-up. No tumor recurrence or instability is noted. shows MRI taken at 2-year follow-up. No tumor recurrence or instability is noted.']} | Anterior Reconstruction of C2–C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique | [
"anterior C1 sublaminar wiring",
"cervical",
"osteoblastoma",
"pediatric spine"
] | Global Spine J | 1454745600 | Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1-C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1-C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2-C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2-C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies. | [] | other | PMC4733373 | null | 36 | [
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] | Global Spine J. 2016 Feb 6; 6(1):e21-e29 | NO-CC CODE |
|
Cervical magnetic resonance imaging (axial images): arrow shows the right vertebral artery that is encompassed by the mass. | 10-1055-s-0035-1550340-i1400085-5 | 7 | 05bddc4aced8118b83d9f1f2a698d75f04db62e8cb95a6a0cbe08329e705ab62 | 10-1055-s-0035-1550340-i1400085-5.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
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800,
667
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(B) Cervical MRI (T2-weighted): 10 months before the operation.', 'hash': '17e7c8bc80ca4e41f14e23f16ea9da6162daec589d29cacd9b92cc4e357474bf'}, {'image_id': '10-1055-s-0035-1550340-i1400085-6', 'image_file_name': '10-1055-s-0035-1550340-i1400085-6.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-6.jpg', 'caption': 'Multidetector computed tomography angiogram of neck and skull base: arrow shows right C2 segment vertebral artery occlusion.', 'hash': '37a2299d28615f94b9070585db302fc2c23acb96c59634f8b7a16bae4868cc66'}, {'image_id': '10-1055-s-0035-1550340-i1400085-11', 'image_file_name': '10-1055-s-0035-1550340-i1400085-11.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-11.jpg', 'caption': 'Excised mass hematoxylin and eosin histopathology.', 'hash': '3f99f6167ef6f066298a758ae3dd6faac4f28816c323b50df894f843c5b21962'}, {'image_id': '10-1055-s-0035-1550340-i1400085-7', 'image_file_name': '10-1055-s-0035-1550340-i1400085-7.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-7.jpg', 'caption': '(A) First operation: arrow points to the bony texture of posterior part of the tumor that required drilling. (B) First operation: final posterior fixation. Arrow shows posterior C1 arc.', 'hash': 'a38b780c953ece1066f71ce8cc8cd208dbfa73f0e6cd7f6bccb76303229972d5'}, {'image_id': '10-1055-s-0035-1550340-i1400085-9', 'image_file_name': '10-1055-s-0035-1550340-i1400085-9.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-9.jpg', 'caption': '(A) Second operation: arrow shows anterior arc of C1. (B) Second operation: implant fixed to C1 with sublaminar wiring technique.', 'hash': '674105e3705e542a97489f073cb598912dc3f6772399033e34a3858022405d14'}, {'image_id': '10-1055-s-0035-1550340-i1400085-10', 'image_file_name': '10-1055-s-0035-1550340-i1400085-10.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-10.jpg', 'caption': 'Second operation: postoperative X-ray.', 'hash': 'e4bddcd4adc5f3681ceb51b27649235c031266106898f4fa3e6918cdcf87beab'}, {'image_id': '10-1055-s-0035-1550340-i1400085-3', 'image_file_name': '10-1055-s-0035-1550340-i1400085-3.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-3.jpg', 'caption': '(A) Cervical computed tomography (CT), sagittal reformat: calcified mass of C2 that also affected C3. (B) Cervical CT, axial view: arrow points to the well demarcated calcified lesion involving body and right side posterior element of C2.', 'hash': '725f507c44995db4058525eba1fbce9e603aab198447b9465c9a8177b52928c9'}, {'image_id': '10-1055-s-0035-1550340-i1400085-4', 'image_file_name': '10-1055-s-0035-1550340-i1400085-4.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-4.jpg', 'caption': '(A) Cervical magnetic resonance imaging (MRI; T2-weighted): inhomogeneous mass extending from clivus to C4. (B) Cervical MRI (T1-weighted). (C) Cervical MRI (gadolinium-enhanced): enhancing mass destructed C2 and C3 vertebra.', 'hash': 'b0a3aa054b34e62c20b24265fb98486c2602244380380b13dd2e3bc70b2fbfd7'}, {'image_id': '10-1055-s-0035-1550340-i1400085-12', 'image_file_name': '10-1055-s-0035-1550340-i1400085-12.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-12.jpg', 'caption': '(A) Thirty-month follow-up plain X-ray. (B) Thirty-month follow-up plain X-ray (flexion view). (C) Thirty-month follow-up plain X-ray (extension view). (D) Two-year follow-up magnetic resonance imaging.', 'hash': '0ae43c6843909a1536f121859a4270f001b3fa6c441a517e1644cdaa7fac82de'}, {'image_id': '10-1055-s-0035-1550340-i1400085-5', 'image_file_name': '10-1055-s-0035-1550340-i1400085-5.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-5.jpg', 'caption': 'Cervical magnetic resonance imaging (axial images): arrow shows the right vertebral artery that is encompassed by the mass.', 'hash': '05bddc4aced8118b83d9f1f2a698d75f04db62e8cb95a6a0cbe08329e705ab62'}, {'image_id': '10-1055-s-0035-1550340-i1400085-2', 'image_file_name': '10-1055-s-0035-1550340-i1400085-2.jpg', 'image_path': '../data/media_files/PMC4733373/10-1055-s-0035-1550340-i1400085-2.jpg', 'caption': 'Cervical X-ray: Arrows show the erosion of vertebral body and posterior elements of C2–C3 by the expansile mass.', 'hash': '1b94d0826b8f899f3e978e119a1b34358227a38b64faf53626c0d9e7ee2156ee'}] | {'10-1055-s-0035-1550340-i1400085-1': ['A 6-year-old boy was referred to our department by a neurosurgeon for a newly developed neck skew and aggravation of neck pain that had been bothering the patient for 2 years. Prior to his visit at our department, he was under a 2-year follow-up by several pediatricians for neck pain and pain on neck motion. Magnetic resonance imaging (MRI) was obtained at that time but did not show a significant finding (<xref rid="10-1055-s-0035-1550340-i1400085-1" ref-type="fig">Fig. 1A, B</xref>). When we visited the patient, in addition to neck skew and pain, he complained of difficulty swallowing. Neck pain worsened at night with no significant response to aspirin. His past medical history and family history for malignancy was unremarkable.). When we visited the patient, in addition to neck skew and pain, he complained of difficulty swallowing. Neck pain worsened at night with no significant response to aspirin. His past medical history and family history for malignancy was unremarkable.'], '10-1055-s-0035-1550340-i1400085-2': ['Chest X-ray was unremarkable. Cervical X-ray (<xref rid="10-1055-s-0035-1550340-i1400085-2" ref-type="fig">Fig. 2</xref>) revealed an expansile lesion that eroded the vertebral body and posterior elements of C2–C3. Spiral axial computed tomography (CT) scan of the cervical column () revealed an expansile lesion that eroded the vertebral body and posterior elements of C2–C3. Spiral axial computed tomography (CT) scan of the cervical column (<xref rid="10-1055-s-0035-1550340-i1400085-3" ref-type="fig">Fig. 3A, B</xref>) depicted a large 36\u2009×\u200933\u2009×\u200927-mm calcified mass of C2 that caused deformity of C2 and also affected C3 with severe pressure erosion of the odontoid process. Secondary spinal canal narrowing was also noted (anteroposterior canal diameter: 8 mm). MRI () depicted a large 36\u2009×\u200933\u2009×\u200927-mm calcified mass of C2 that caused deformity of C2 and also affected C3 with severe pressure erosion of the odontoid process. Secondary spinal canal narrowing was also noted (anteroposterior canal diameter: 8 mm). MRI (<xref rid="10-1055-s-0035-1550340-i1400085-4" ref-type="fig">Fig. 4A, B</xref>) revealed an expansile, well-demarcated, inhomogeneous (iso- and hypointense in T1-weighted images and hypo- and hyperintense in T2-weighted images) mass that extended from the clivus to C4. Gadolinium-enhanced images () revealed an expansile, well-demarcated, inhomogeneous (iso- and hypointense in T1-weighted images and hypo- and hyperintense in T2-weighted images) mass that extended from the clivus to C4. Gadolinium-enhanced images (<xref rid="10-1055-s-0035-1550340-i1400085-4" ref-type="fig">Fig. 4C</xref>) depicted destruction of the C2 and C3 vertebra (the odontoid process, right facet joints, and both vertebral bodies). Axial MRIs displayed encircling of right vertebral artery () depicted destruction of the C2 and C3 vertebra (the odontoid process, right facet joints, and both vertebral bodies). Axial MRIs displayed encircling of right vertebral artery (<xref rid="10-1055-s-0035-1550340-i1400085-5" ref-type="fig">Fig. 5</xref>).).'], '10-1055-s-0035-1550340-i1400085-6': ['Multidetector CT angiogram of the neck and skull base (<xref rid="10-1055-s-0035-1550340-i1400085-6" ref-type="fig">Fig. 6</xref>) showed right vertebral artery lateral displacement by a huge C2 lobulated mass that was abutting the right vertebral artery. Whole-body bone scan by Tc-99m-methylene diphosphonate was also performed, which showed an abnormally increased uptake of radioactive uptake in C2. Results of CT-guided C2 needle biopsy were highly suggestive of osteoblastoma.) showed right vertebral artery lateral displacement by a huge C2 lobulated mass that was abutting the right vertebral artery. Whole-body bone scan by Tc-99m-methylene diphosphonate was also performed, which showed an abnormally increased uptake of radioactive uptake in C2. Results of CT-guided C2 needle biopsy were highly suggestive of osteoblastoma.'], '10-1055-s-0035-1550340-i1400085-7': ['The patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of the C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. The posterior fixation of C1–C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Intraoperative images are shown in <xref rid="10-1055-s-0035-1550340-i1400085-7" ref-type="fig">Fig. 7</xref>. . <xref rid="10-1055-s-0035-1550340-i1400085-8" ref-type="fig">Fig. 8A, B</xref> shows X-ray and CT after the first operation. After 10 days, total resection of residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath; shows X-ray and CT after the first operation. After 10 days, total resection of residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath; <xref rid="10-1055-s-0035-1550340-i1400085-9" ref-type="fig">Fig. 9A, B</xref>). The vertebral artery was obliterated. Due to a thin C1 arch and the absence of good bony purchase for screws, we used anterior sublaminar wiring for C1 and reconstructed the C2–C3 bodies with an expandable cage. The lower end of the implant was screwed to C4. ). The vertebral artery was obliterated. Due to a thin C1 arch and the absence of good bony purchase for screws, we used anterior sublaminar wiring for C1 and reconstructed the C2–C3 bodies with an expandable cage. The lower end of the implant was screwed to C4. <xref rid="10-1055-s-0035-1550340-i1400085-10" ref-type="fig">Fig. 10</xref> displays the X-ray after the second operation. displays the X-ray after the second operation.'], '10-1055-s-0035-1550340-i1400085-11': ['The pathologic examination (<xref rid="10-1055-s-0035-1550340-i1400085-11" ref-type="fig">Fig. 11</xref>) showed osteoblasts suggestive of osteoblastoma.) showed osteoblasts suggestive of osteoblastoma.'], '10-1055-s-0035-1550340-i1400085-12': ['\n<xref rid="10-1055-s-0035-1550340-i1400085-12" ref-type="fig">Fig. 12A, B, C</xref> demonstrates plain X-rays. demonstrates plain X-rays. <xref rid="10-1055-s-0035-1550340-i1400085-12" ref-type="fig">Fig. 12D</xref> shows MRI taken at 2-year follow-up. No tumor recurrence or instability is noted. shows MRI taken at 2-year follow-up. No tumor recurrence or instability is noted.']} | Anterior Reconstruction of C2–C3 Bodies in a 6-Year-Old Patient with a Huge Osteoblastoma: A Novel Technique | [
"anterior C1 sublaminar wiring",
"cervical",
"osteoblastoma",
"pediatric spine"
] | Global Spine J | 1454745600 | Study Design Case report. Objective We report the youngest child diagnosed with upper cervical osteoblastoma and the first case operated on with our novel surgical approach. Methods Our patient underwent a two-stage surgery. During the first operation via a posterior approach, a subtotal resection of a C2 bony mass was performed. C3 was also subtotally resected due to tumor extension. Posterior fixation of C1-C5 was performed by C1 sublaminar hooks and C4 and C5 lateral mass screws. Ten days later, a total resection of the residual bony mass was performed through an anterior approach (between the sternocleidomastoid muscle and carotid sheath). Reconstruction of C1-C3 was performed with C1 anterior sublaminar wiring and an expandable titanium cage. Results Successful reconstruction of C2-C3 vertebral bodies was achieved. At 2-year follow-up, the child was symptom-free. Imaging studies revealed no recurrence of tumor or instability. Conclusion A novel technique for reconstruction of C2-C3 vertebral bodies is demonstrated for the youngest case (a 6-year-old boy) of osteoblastoma in the literature. We recommend this approach for cervical spine reconstruction in patients who have an intact C1 arc and resected lower bodies. | [] | other | PMC4733373 | null | 36 | [
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] | Global Spine J. 2016 Feb 6; 6(1):e21-e29 | NO-CC CODE |
|
Preoperative sagittal T2-weighted magnetic resonance imaging (MRI) (A) of the thoracic spine revealing multiple intradural tumors as well as an axial T2-weighted MRI (B) revealing significant compression of the spinal cord. | 10-1055-s-0035-1550087-i1400097-1 | 7 | d4c1c956dc263bd3b7b203763bf697515fdf74e4cce0a427b2bbef1249e0e23d | 10-1055-s-0035-1550087-i1400097-1.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
390
] | [{'image_id': '10-1055-s-0035-1550087-i1400097-1', 'image_file_name': '10-1055-s-0035-1550087-i1400097-1.jpg', 'image_path': '../data/media_files/PMC4733380/10-1055-s-0035-1550087-i1400097-1.jpg', 'caption': 'Preoperative sagittal T2-weighted magnetic resonance imaging (MRI) (A) of the thoracic spine revealing multiple intradural tumors as well as an axial T2-weighted MRI (B) revealing significant compression of the spinal cord.', 'hash': 'd4c1c956dc263bd3b7b203763bf697515fdf74e4cce0a427b2bbef1249e0e23d'}, {'image_id': '10-1055-s-0035-1550087-i1400097-3', 'image_file_name': '10-1055-s-0035-1550087-i1400097-3.jpg', 'image_path': '../data/media_files/PMC4733380/10-1055-s-0035-1550087-i1400097-3.jpg', 'caption': 'Preprocedure computed tomography scan of the head to ensure the ventricular size could accommodate an external ventricular drain (A). Postprocedure scan showing successful placement of a right frontal external ventricular drain (B).', 'hash': 'cffa09b390c9de0036418e3881b5d058f77eb7d6ffdfe833ac4df02998cbca75'}, {'image_id': '10-1055-s-0035-1550087-i1400097-2', 'image_file_name': '10-1055-s-0035-1550087-i1400097-2.jpg', 'image_path': '../data/media_files/PMC4733380/10-1055-s-0035-1550087-i1400097-2.jpg', 'caption': 'Postoperative T2-weighted sagittal (A) and axial (B) magnetic resonance imaging revealing gross total resection of multiple intradural tumors. Radiographic evidence of a refractory thoracolumbar cerebrospinal fluid leak was not readily evident on the immediate postoperative films.', 'hash': '69a89e5b202ec4d1564b6c061567bb5d1ea518744aaea6a3c4ac895169e6706a'}] | {'10-1055-s-0035-1550087-i1400097-1': ['The 32-year-old man had a history of spinal myxopapillary ependymoma World Health Organization (WHO) grade I with local metastatic spinal disease. The patient first presented in 2005 with a 1-year history of severe low back pain. He was found to have an intradural lesion, and subsequently had a T12–L3 laminectomy for resection of the tumor. Small amounts of the tumor adherent to the nerve roots were purposefully left behind. Each time an attempt was made to remove these residual small pieces of the tumor, significant amounts of neuromonitoring activity was noted. Hence, the residual tumor was left behind so as to not cause a neurologic deficit. Approximately 10 days after surgery, the patient fell at home and noticed significant amounts of a clear fluid consistent with CSF leaking from his incision. He was taken to the operating room at that time and a dural defect was identified and closed primarily, then covered with Gelfoam (Baxter Healthcare, Deerfield, IL, United States) and Tisseel (Baxter Healthcare). The patient again noted another CSF leak from a different area of his incision 5 days later, and he was taken back to the operating room for another primary closure, as well as placement of a fat graft and more Tisseel. Adjuvant radiation treatment was undertaken after he recovered from the initial surgeries. In 2008, the patient presented again with signs and symptoms from thoracic spinal cord compression. He was found to have a dorsally located intradural lesion at the T8–T9 region, which was resected via a T7–T10 laminectomy. In 2010, the patient presented with progressive low back pain and radicular symptoms. He was found to have growing intradural lesions at L4 and L5. At that time, L4–S1 laminectomies for the resection of three separate tumors was undertaken. One year later, our patient presented yet again with multiple thoracolumbar intradural lesions (<xref rid="10-1055-s-0035-1550087-i1400097-1" ref-type="fig">Fig. 1</xref>). He underwent redo decompressive laminectomies from T8–S1 with a total of 13 intradural tumors being excised (). He underwent redo decompressive laminectomies from T8–S1 with a total of 13 intradural tumors being excised (<xref rid="10-1055-s-0035-1550087-i1400097-2" ref-type="fig">Fig. 2</xref>). The dural closure proved to be quite complex, as there were several areas that were macerated and very difficult to reapproximate. Fat grafts, Duraform (DePuy Synthes, West Chester, PA, United States), and Tisseel were all used on top of the attempted primary dural closure.). The dural closure proved to be quite complex, as there were several areas that were macerated and very difficult to reapproximate. Fat grafts, Duraform (DePuy Synthes, West Chester, PA, United States), and Tisseel were all used on top of the attempted primary dural closure.'], '10-1055-s-0035-1550087-i1400097-3': ['During his hospital course, the patient developed a spontaneous CSF leak from his wound. It was initially treated by oversewing the skin, but the leak persisted over the next day. We decided to bring the patient back to the operating room for an exploration and an attempt at repairing the dural defects. Multiple dural defects were noted. As a result of the significant dural maceration, another primary closure was not attempted. We placed more pieces of Duraform, fat graft, and Tisseel over the areas of CSF leakage, and we again performed a tight multilayer closure of the muscle, fascia, fat, and subcutaneous tissue. Despite our best efforts to stop the CSF leak, the leak continued through the incisions from multiple areas. The patient then began showing clinical signs of meningitis. As a last resort, we decided to place a right frontal external ventricular drain (EVD; Integra Life Sciences, Plainsboro, NJ, United States) after obtaining a preprocedure computed tomography scan of the head, to ensure the ventricular size could accommodate the catheter (<xref rid="10-1055-s-0035-1550087-i1400097-3" ref-type="fig">Fig. 3A</xref>). The EVD was successfully placed (). The EVD was successfully placed (<xref rid="10-1055-s-0035-1550087-i1400097-3" ref-type="fig">Fig. 3B</xref>) and kept for 11 days. The patient\'s hospital course was further complicated by pneumonia and reintubation. He was placed on antibiotics for both the pneumonia as well as the CSF leak and subsequent meningitis. On the day 8 of the EVD in place, we continued to see cessation of the CSF leak and decided to perform a 3-day clamping trial. No further CSF leak was noted from the incision during the clamping trial. The EVD was removed, and the patient was eventually discharged home without further complications.) and kept for 11 days. The patient\'s hospital course was further complicated by pneumonia and reintubation. He was placed on antibiotics for both the pneumonia as well as the CSF leak and subsequent meningitis. On the day 8 of the EVD in place, we continued to see cessation of the CSF leak and decided to perform a 3-day clamping trial. No further CSF leak was noted from the incision during the clamping trial. The EVD was removed, and the patient was eventually discharged home without further complications.']} | Refractory Thoracolumbar Cerebrospinal Fluid Leak after Multiple Spinal Ependymoma Resections Treated with External Ventricular Drainage | [
"external ventricular drain",
"cerebrospinal fluid leak",
"ependymoma",
"dural defect"
] | Global Spine J | 1454745600 | Study Design Case report. Objective Temporary external ventricular drainage for refractory thoracolumbar cerebrospinal fluid (CSF) leak is not reported in the literature. We describe a recent case that utilized this technique. Methods Retrospective review of the patient's case notes was performed and the literature on this subject reviewed. Results The patient underwent multiple complex spinal surgeries for resection of innumerable metastatic ependymoma lesions. A case of significant refractory CSF leak developed and as a last resort a right frontal external ventricular drain was placed. The CSF leak ceased, and the patient was eventually discharged home without further complication. Conclusion External ventricular drainage can be a viable option for temporary proximal CSF diversion to treat refractory thoracolumbar CSF leaks. | [] | other | PMC4733380 | null | 6 | [
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] | Global Spine J. 2016 Feb 6; 6(1):e11-e14 | NO-CC CODE |
|
Magnetic resonance imaging showing cord compression with myelomalacia in the region of C1–C2. | 10-1055-s-0035-1555660-i1400162-8 | 7 | 387777f9029c98b4b9a4bd84367affc79e971f81a4e7b28f1321d59d9bc7e612 | 10-1055-s-0035-1555660-i1400162-8.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
800,
755
] | [{'image_id': '10-1055-s-0035-1555660-i1400162-5', 'image_file_name': '10-1055-s-0035-1555660-i1400162-5.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-5.jpg', 'caption': 'Follow-up lateral (a) and anteroposterior (b) radiographs showing solid radiographic union and maintained occipitocervical alignment.', 'hash': '1a6201f7929b4127a317e762cfce89e1d6fe995f162bb0c4191e3bed3d427284'}, {'image_id': '10-1055-s-0035-1555660-i1400162-2', 'image_file_name': '10-1055-s-0035-1555660-i1400162-2.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-2.jpg', 'caption': 'Computed tomography scan showing abnormal widening at C1–C2. The ossicle terminal portion of the nonfused pediatric odontoid was noted to be superiorly located through the region of the foramen magnum.', 'hash': '9a5f38999f9815599748b34fefabdfee0c7cde55995a252fa2420dcb1e619671'}, {'image_id': '10-1055-s-0035-1555660-i1400162-3', 'image_file_name': '10-1055-s-0035-1555660-i1400162-3.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-3.jpg', 'caption': 'Magnetic resonance imaging with severe canal stenosis and myelomalacia in the region of C1–C2.', 'hash': '3101b63bb0dc252cfe363a757e0c4de060004862f2648a22e31d7cca171cc12c'}, {'image_id': '10-1055-s-0035-1555660-i1400162-4', 'image_file_name': '10-1055-s-0035-1555660-i1400162-4.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-4.jpg', 'caption': 'Postoperative magnetic resonance imaging demonstrated excellent decompression of the spinal canal.', 'hash': '1b23ee7ba8e8d903226b68daa5a3f6800f3fedcfa66ed553ed456dabeebada0e'}, {'image_id': '10-1055-s-0035-1555660-i1400162-7', 'image_file_name': '10-1055-s-0035-1555660-i1400162-7.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-7.jpg', 'caption': 'Computed tomography scan showing abnormal widening at C1–C2. The ossicle terminal portion of the nonfused pediatric odontoid is displaced anteriorly.', 'hash': 'a6c57d58e5b7d11dbd8107506d74ede3864129179963f9b35ad2d40376fbff1c'}, {'image_id': '10-1055-s-0035-1555660-i1400162-9', 'image_file_name': '10-1055-s-0035-1555660-i1400162-9.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-9.jpg', 'caption': 'Follow-up extension (a) and flexion (b) radiographs demonstrating maintained occipitocervical alignment and solid union.', 'hash': '88723b4375729318f18167392b745e6e4baab25a2360df1eef2811aecb8037d6'}, {'image_id': '10-1055-s-0035-1555660-i1400162-8', 'image_file_name': '10-1055-s-0035-1555660-i1400162-8.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-8.jpg', 'caption': 'Magnetic resonance imaging showing cord compression with myelomalacia in the region of C1–C2.', 'hash': '387777f9029c98b4b9a4bd84367affc79e971f81a4e7b28f1321d59d9bc7e612'}, {'image_id': '10-1055-s-0035-1555660-i1400162-1', 'image_file_name': '10-1055-s-0035-1555660-i1400162-1.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-1.jpg', 'caption': 'Lateral radiograph demonstrating severe C1–C2 instability with a widened atlanto-dens interval and narrowed posterior atlanto-dens interval.', 'hash': '7dd85ba1844ba910cce6e7720c837d2dd629ebc4f4331ce666a08712770f3016'}, {'image_id': '10-1055-s-0035-1555660-i1400162-6', 'image_file_name': '10-1055-s-0035-1555660-i1400162-6.jpg', 'image_path': '../data/media_files/PMC4733381/10-1055-s-0035-1555660-i1400162-6.jpg', 'caption': 'Lateral radiographs demonstrating severe C1–C2 instability with a widened atlanto-dens interval and severely narrowed posterior atlanto-dens interval.', 'hash': '687789ae4b2ce9184701fdbcc6283ec947578fe3e7c30be4764808bcdb8ce358'}] | {'10-1055-s-0035-1555660-i1400162-1': ['A 9-year-old boy with developmental delay and trisomy 16 presented to the emergency room with severe neck pain and a 4-week history of progressive weakness in all four extremities and difficulty ambulating. The radiographs demonstrated severe C1–C2 instability with a widened atlanto-dens interval and a narrowed posterior atlanto-dens interval (<xref rid="10-1055-s-0035-1555660-i1400162-1" ref-type="fig">Fig. 1</xref>). Computed tomography (CT) scan showed hypoplasia of the atlas condyles along with an intact posterior arch. The ossicle terminal portion of the nonfused pediatric odontoid was noted to be superiorly located through the region of the foramen magnum (). Computed tomography (CT) scan showed hypoplasia of the atlas condyles along with an intact posterior arch. The ossicle terminal portion of the nonfused pediatric odontoid was noted to be superiorly located through the region of the foramen magnum (<xref rid="10-1055-s-0035-1555660-i1400162-2" ref-type="fig">Fig. 2</xref>). Magnetic resonance imaging (MRI) revealed severe canal stenosis and myelomalacia in the C1–C2 region (). Magnetic resonance imaging (MRI) revealed severe canal stenosis and myelomalacia in the C1–C2 region (<xref rid="10-1055-s-0035-1555660-i1400162-3" ref-type="fig">Fig. 3</xref>).).'], '10-1055-s-0035-1555660-i1400162-4': ['Occipitocervical stabilization and fusion surgery was recommended. There was concern regarding a paucity of available autogenous bone graft due to the patient\'s relatively younger age and small body stature. Other concerns included the potential for poor iliac crest wound healing and increased graft site pain. The potential risks and benefits of off-label BMP use were discussed with the parents preoperatively. Informed consent was obtained from the parents after a thorough discussion of the existing BMP potential complication literature and the concept of off-label use. The surgery was performed using occipital plating and subaxial fixation including bilateral C2 translaminar screws and C3 lateral mass screws. One large kit of Infuse recombinant human (rh)-BMP-2 (12 mg) (Medtronic, Minneapolis, MN, United States) was placed on a 7.5\u2009×\u200910-cm collagen sponge and combined with 20 mL Mastergraft extender product (Medtronic), which is purified bovine collagen combined with biphasic calcium phosphate ceramic. No other bone grafting materials were used. The surgery was performed without intraoperative complications. The postoperative MRI demonstrated excellent decompression of the spinal canal (<xref rid="10-1055-s-0035-1555660-i1400162-4" ref-type="fig">Fig. 4</xref>).).'], '10-1055-s-0035-1555660-i1400162-5': ['The patient\'s postoperative course was uneventful, and he was discharged to home on postoperative day 5. His neurologic motor function improved significantly, and his wound healed primarily without any reported problems during the weeks following the surgery. He was followed regularly as an outpatient for 62 months postoperatively. Solid radiographic union was achieved without loss of occipitocervical alignment. The lateral radiograph demonstrated extension of the fusion to include two levels below the instrumentation levels, which may be associated with either surgical exposure or the BMP-2 use. There was no evidence of implant breakage or loosening (<xref rid="10-1055-s-0035-1555660-i1400162-5" ref-type="fig">Fig. 5a, b</xref>).).'], '10-1055-s-0035-1555660-i1400162-6': ['A 9-year-old girl with Down syndrome fell off a chair in her home and presented to the emergency room with incomplete quadriplegia (American Spinal Injury Association classification B) and severe neck pain.6 Radiographs revealed severe C1–C2 instability with a widened atlanto-dens interval and a severely narrowed posterior atlanto-dens interval. The CT showed hypoplasia of the C1 lateral masses with an intact posterior C1 arch. The MRI demonstrated cord compression with myelomalacia in the C1–C2 region (<xref rid="10-1055-s-0035-1555660-i1400162-6" ref-type="fig">Figs. 6</xref>, , <xref rid="10-1055-s-0035-1555660-i1400162-7" ref-type="fig">7</xref>, , <xref rid="10-1055-s-0035-1555660-i1400162-8" ref-type="fig">8</xref>).).'], '10-1055-s-0035-1555660-i1400162-9': ['The patient\'s postoperative course was uneventful, and her neurologic function improved during the postoperative hospitalization. Primary wound healing without complication was noted. At the time of ultimate follow-up (61 months), the patient remained neurologically normal with maintained occipitocervical alignment. Solid union was noted on follow-up flexion and extension radiographs without evidence of broken instrumentation (<xref rid="10-1055-s-0035-1555660-i1400162-9" ref-type="fig">Fig. 9a, b</xref>). The lateral radiograph demonstrates extension of the fusion to include one level below the instrumentation levels, which may be associated with either surgical exposure or the BMP-2 use.). The lateral radiograph demonstrates extension of the fusion to include one level below the instrumentation levels, which may be associated with either surgical exposure or the BMP-2 use.']} | The Use of Bone Morphogenetic Protein in Pediatric Cervical Spine Fusion Surgery: Case Reports and Review of the Literature | [
"BMP",
"bone morphogenic protein",
"rh-BMP-2",
"bone graft substitutes",
"pediatric cervical spine"
] | Global Spine J | 1455609600 | Study Design Case report. Objective There is a paucity of literature describing the use of bone graft substitutes to achieve fusion in the pediatric cervical spine. The outcomes and complications involving the off-label use of bone morphogenetic protein (BMP)-2 in the pediatric cervical spine are not clearly defined. The purpose of this article is to report successful fusion without complications in two pediatric patients who had instrumented occipitocervical fusion using low-dose BMP-2. Methods A retrospective review of the medical records was performed, and the patients were followed for 5 years. Two patients under 10 years of age with upper cervical instability were treated with occipitocervical instrumented fusion using rigid occipitocervical fixation techniques along with conventionally available low-dose BMP-2. A Medline and PubMed literature search was conducted using the terms "bone morphogenetic protein," "BMP," "rh-BMP2," "bone graft substitutes," and "pediatric cervical spine." Results Solid occipitocervical fusion was achieved in both pediatric patients. There were no reported perioperative or follow-up complications. At 5-year follow-up, radiographs in both patients showed successful occipital cervical fusion without evidence of instrumentation failure or changes in the occipitocervical alignment. To date, there are few published reports on this topic. Complications and the appropriate dosage application in the pediatric posterior cervical spine remain unknown. Conclusions We describe two pediatric patients with upper cervical instability who achieved successful occipital cervical fusion without complication using off-label BMP-2. This report underscores the potential for BMP-2 to achieve successful arthrodesis of the posterior occipitocervical junction in pediatric patients. Use should be judicious as complications and long-term outcomes of pediatric BMP-2 use remain undefined in the existing literature. | [] | other | PMC4733381 | null | 15 | [
"{'Citation': 'Haft G F Is off-label use of BMP in pediatric spine surgery now a standard of care? Commentary on an article by Amit Jain, MD, et al.: “Factors associated with use of bone morphogenetic protein during pediatric spinal fusion surgery. an analysis of 4817 patients.” J Bone Joint Surg Am 20139514e103, 1–2', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23864186'}}}",
"{'Citation': 'Hwang S W, Gressot L V, Rangel-Castilla L. et al.Outcomes of instrumented fusion in the pediatric cervical spine. J Neurosurg Spine. 2012;17(5):397–409.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '22998404'}}}",
"{'Citation': 'Jain A, Kebaish K M, Sponseller P D. Factors associated with use of bone morphogenetic protein during pediatric spinal fusion surgery: an analysis of 4817 patients. J Bone Joint Surg Am. 2013;95(14):1265–1270.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23864174'}}}",
"{'Citation': 'Mladenov K V, Kunkel P, Stuecker R. The use of recombinant human BMP-2 as a salvage procedure in the pediatric spine: a report on 3 cases. Eur Spine J. 2010;19 02:S135–S139.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC2899647'}, {'@IdType': 'pubmed', '#text': '19876660'}]}}",
"{'Citation': 'Pakkasjärvi N, Mattila M, Remes V, Helenius I. Upper cervical spine fusion in children with skeletal dysplasia. Scand J Surg. 2013;102(3):189–196.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '23963034'}}}",
"{'Citation': 'Maynard F M Jr, Bracken M B, Creasey G. et al.International Standards for Neurological and Functional Classification of Spinal Cord Injury. Spinal Cord. 1997;35(5):266–274.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '9160449'}}}",
"{'Citation': 'Savage J G, Fulkerson D H, Sen A N, Thomas J G, Jea A. Fixation with C-2 laminar screws in occipitocervical or C1–2 constructs in children 5 years of age or younger: a series of 18 patients. J Neurosurg Pediatr. 2014;14(1):87–93.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '24784980'}}}",
"{'Citation': 'Aspenberg P. Under-reported complications related to BMP use in spine surgery. Acta Orthop. 2011;82(5):511–512.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3242945'}, {'@IdType': 'pubmed', '#text': '21992083'}]}}",
"{'Citation': 'Carragee E J, Chu G, Rohatgi R. et al.Cancer risk after use of recombinant bone morphogenetic protein-2 for spinal arthrodesis. J Bone Joint Surg Am. 2013;95(17):1537–1545.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '24005193'}}}",
"{'Citation': 'Epstein N E. Complications due to the use of BMP/INFUSE in spine surgery: the evidence continues to mount. Surg Neurol Int. 2013;4 05:S343–S352.', 'ArticleIdList': {'ArticleId': [{'@IdType': 'pmc', '#text': 'PMC3717531'}, {'@IdType': 'pubmed', '#text': '23878769'}]}}",
"{'Citation': 'Tannoury C A, An H S. Complications with the use of bone morphogenetic protein 2 (BMP-2) in spine surgery. Spine J. 2014;14(3):552–559.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '24412416'}}}",
"{'Citation': 'Rocque B G, Kelly M P, Miller J H, Li Y, Anderson P A. Bone morphogenetic protein-associated complications in pediatric spinal fusion in the early postoperative period: an analysis of 4658 patients and review of the literature. J Neurosurg Pediatr. 2014;14(6):635–643.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '25303159'}}}",
"{'Citation': 'Lu D C Sun P P Bone morphogenetic protein for salvage fusion in an infant with Down syndrome and craniovertebral instability. Case report J Neurosurg 2007106(6, Suppl):480–483.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '17566406'}}}",
"{'Citation': 'Oluigbo C O, Solanki G A. Use of recombinant human bone morphogenetic protein-2 to enhance posterior cervical spine fusion at 2 years of age: technical note. Pediatr Neurosurg. 2008;44(5):393–396.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '18703886'}}}",
"{'Citation': 'Mazur M D, Sivakumar W, Riva-Cambrin J, Jones J, Brockmeyer D L. Avoiding early complications and reoperation during occipitocervical fusion in pediatric patients. J Neurosurg Pediatr. 2014;14(5):465–475.', 'ArticleIdList': {'ArticleId': {'@IdType': 'pubmed', '#text': '25171720'}}}"
] | Global Spine J. 2016 Feb 16; 6(1):e41-e46 | NO-CC CODE |
|
Grade 3 perianal fistula; transsphincteric fistula without an abscess. Axial (A) and coronal (C, D) T2-weighted, axial (B) and coronal (E, F) contrast-enhanced fat-suppressed T1-weighted MR images show the transsphincteric fistula (arrows) crossing the external sphincter. Axial (B), and coronal (E, F) contrast-enhanced fat-suppressed T1-weighted MR images show the highly enhancing transsphincteric fistula (arrows). | poljradiol-79-490-g006 | 7 | 8e81a66afceccd40dc129b01d173d6949e702433093e5899fa5545a0f4623f3b | poljradiol-79-490-g006.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
780,
414
] | [{'image_id': 'poljradiol-79-490-g005', 'image_file_name': 'poljradiol-79-490-g005.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g005.jpg', 'caption': 'Grade 3 perianal fistula; transsphincteric fistula without an abscess. Axial T1-weighted (A) and T2-weighted (B), axial (C) and coronal (D) contrast-enhanced fat-suppressed T1-weighted MR images show the transsphincteric fistula (arrows) crossing the external sphincter. Axial (C), and coronal (D) contrast-enhanced fat-suppressed T1-weighted MR images show the highly enhancing transsphincteric fistula (arrows).', 'hash': '2534e507e1ee22f5f4da17d6d6f57cdb8e4434c5ea7633be94cc3034d50577ea'}, {'image_id': 'poljradiol-79-490-g002', 'image_file_name': 'poljradiol-79-490-g002.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g002.jpg', 'caption': 'Grade 1 perianal fistula; linear intersphincteric. Axial (A) and coronal (B) contrast-enhanced fat-suppressed T1-weighted MR images show contrast enhancement of the left posterolateral intersphincteric fistula (arrows) surrounded by the external sphincter without an abscess.', 'hash': '1cf919f45fbfc49fdb1931dfd53a937ebaf06bdd49059010699f9168241224bc'}, {'image_id': 'poljradiol-79-490-g003', 'image_file_name': 'poljradiol-79-490-g003.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g003.jpg', 'caption': 'Grade 2 perianal fistula; intersphincteric fistula with an abscess. Axial (A) and coronal (D) T2-weighted, axial (B) and coronal (E) fat-suppressed T2-weighted MR images show high-intensity fluid collection along the right posterolateral aspect of the anal canal (arrows). Axial (C) and coronal (F) contrast-enhanced fat-suppressed T1-weighted MR images show a peripherally enhancing abscess in the intersphincteric space (arrowheads).', 'hash': '1ee2e9244649f7b6ddffe8e59d09a35fabe01cda5300e29a0531c8df8bf2221c'}, {'image_id': 'poljradiol-79-490-g004', 'image_file_name': 'poljradiol-79-490-g004.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g004.jpg', 'caption': 'Grade 2 perianal fistula; intersphincteric fistula with an abscess. Fistulous tracks, inflammation and abscesses appear as areas of low to intermediate signal intensity and may not be distinguished from normal structures on T1-weighted images (A, arrow). Axial T2-weighted (B), axial (C) and coronal (E) fat-suppressed T2-weighted MR images show high-intensity fluid collection along the posterior wall of the anal canal (arrows). Axial (D) and coronal (F) contrast-enhanced fat-suppressed T1-weighted MR image shows an abscess which is peripherally enhanced (arrowheads) and contains a non-enhancing pus (D, arrow) in the intersphincteric space.', 'hash': '18e49ee53026caad8f2045b173430655539ad9372389e63a1a1e8e832882ed02'}, {'image_id': 'poljradiol-79-490-g007', 'image_file_name': 'poljradiol-79-490-g007.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g007.jpg', 'caption': 'Grade 4 perianal fistula; transsphincteric fistula with an abscess. Axial fat-suppressed T2-weighted (A, B), axial (C, D) and coronal (E, F) contrast-enhanced fat-suppressed T1-weighted MR images show an abscess in the intersphincteric space, located posterior to the anal canal (arrowheads) and transsphincteric fistula (arrows).', 'hash': '4ca4fac135cefec15d0ebcdf12b54ba92f42e5dbea9c3624312f58ae3758c187'}, {'image_id': 'poljradiol-79-490-g009', 'image_file_name': 'poljradiol-79-490-g009.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g009.jpg', 'caption': 'Grade 5 perianal fistula; supralevator and translevator disease. Axial T2-weighted (A–C) and fat-suppressed T2-weighted (D–F), coronal contrast-enhanced fat-suppressed T1-weighted (G–I) MR images show a right translevator fistula (arrows) crossing the ischiorectal fossa which enters the intersphicteric space posterior to the anal canal and continues with a left supralevator abscess (black arrows) with inflammatory changes surrounding the rectum (arrowheads).', 'hash': 'f0a2c2c84f8d41954c9c837c9c0ccdef5a72112202ae2bd0c4cdef0740f1611e'}, {'image_id': 'poljradiol-79-490-g008', 'image_file_name': 'poljradiol-79-490-g008.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g008.jpg', 'caption': 'Grade 4 perianal fistula; transsphincteric fistula with an abscess. Axial T1-weighted (A) and fat-suppressed T2-weighted (B), coronal T2-weighted (D) and fat-suppressed T2-weighted (E), coronal and axial (C, F) contrast-enhanced fat-suppressed T1-weighted MR images show a horseshoe abscess in the intersphincteric space and extending to the ischioanal fossa (arrows) and prominent inflammation around the tract (arrowheads).', 'hash': 'a9f0ea2cadbfde93a55bce251c46ad13394371c319c15ef3d9e8be5041d4c1ab'}, {'image_id': 'poljradiol-79-490-g001', 'image_file_name': 'poljradiol-79-490-g001.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g001.jpg', 'caption': 'Grade 1 perianal fistula; linear intersphincteric. Axial (A) and coronal (B) fat-suppressed T2-weighted, axial contrast-enhanced fat-suppressed T1-weighted (C) MR images show the left intersphincteric fistula (arrows) surrounded by the external sphincter without an abscess or secondary branch. Hyperintense fistula tract on fat-supressed T2-weighted MR images (A, B arrows). Tract enhancement on contrast-enhanced fat-suppressed T1-weighted image (C arrow).', 'hash': '06990e38209725af98f4ded5e5fe4f12ccc7494c1b3b3208eb7dfe48dc53eb90'}, {'image_id': 'poljradiol-79-490-g006', 'image_file_name': 'poljradiol-79-490-g006.jpg', 'image_path': '../data/media_files/PMC4278700/poljradiol-79-490-g006.jpg', 'caption': 'Grade 3 perianal fistula; transsphincteric fistula without an abscess. Axial (A) and coronal (C, D) T2-weighted, axial (B) and coronal (E, F) contrast-enhanced fat-suppressed T1-weighted MR images show the transsphincteric fistula (arrows) crossing the external sphincter. Axial (B), and coronal (E, F) contrast-enhanced fat-suppressed T1-weighted MR images show the highly enhancing transsphincteric fistula (arrows).', 'hash': '8e81a66afceccd40dc129b01d173d6949e702433093e5899fa5545a0f4623f3b'}] | {'poljradiol-79-490-g001': ['T2-weighted sequences with or without fat suppression are essential in evaluation because they provide excellent soft-tissue contrast, and pathological processes including fistulas, secondary fistulous tracks and fluid collections can be clearly depicted. They appear as areas of high signal intensity in contrast to the sphincters, muscles, and fat, i.e. structures of lower signal intensity. To assess fistulous tracts within an acute abscess may be difficult due to high signal intensity on T2-weighted images of pus and edema, which may obscure the underlying fistula tracks. Unenhanced T1-weighted images provide an excellent anatomic overview of the sphincter complex, and the ischiorectal fossae. Fistulous tracks, inflammation, and abscesses, appear as areas of low to intermediate signal intensity and may not be distinguished from normal structures. T1-weighted contrast-enhanced fat-suppressed MRI sequences are used to distinguish inflamed tissues from normal perineal tissues and help to differentiate fluid and scarring/granulation tissue, which is important in distinguishing abscesses (<xref ref-type="fig" rid="poljradiol-79-490-g001">Figures 1</xref>––<xref ref-type="fig" rid="poljradiol-79-490-g009">9</xref>).).', 'In a simple linear intersphincteric fistula, the fistulous track extends from the skin of the perineum or the natal cleft. No secondary extentions or abscesses are detected within the sphincter complex. The enhancing track is seen in the plane between the sphincters and is entirely confined by the external sphincter (<xref ref-type="fig" rid="poljradiol-79-490-g001">Figures 1</xref> and and <xref ref-type="fig" rid="poljradiol-79-490-g002">2</xref>).).'], 'poljradiol-79-490-g003': ['Intersphincteric fistulas with an abscess or secondary track occur within the intersphincteric space. Secondary fistulous tracks may be of the horseshoe type, crossing the midline, or they may branch in the ipsilateral intersphincteric plane. This process is confined within the sphincter complex (<xref ref-type="fig" rid="poljradiol-79-490-g003">Figures 3</xref> and and <xref ref-type="fig" rid="poljradiol-79-490-g004">4</xref>).).'], 'poljradiol-79-490-g005': ['The trans-sphincteric fistula extends through both layers of the sphincter complex and reaches the skin through the ischiorectal and ischioanal fossae. These fistulas are not complicated by the secondary tracks or abscesses. Because these fistulas disrupt the integrity of the sphincter mechanism, their tracks must be excised by dividing both layers of the sphincter, thus risking fecal incontinence (<xref ref-type="fig" rid="poljradiol-79-490-g005">Figures 5</xref> and and <xref ref-type="fig" rid="poljradiol-79-490-g006">6</xref>).).'], 'poljradiol-79-490-g007': ['A trans-sphincteric fistula is complicated by an abscess or extention in the ischiorectal or ischioanal fossae (<xref ref-type="fig" rid="poljradiol-79-490-g007">Figures 7</xref> and and <xref ref-type="fig" rid="poljradiol-79-490-g008">8</xref>).).'], 'poljradiol-79-490-g009': ['In rare cases, perianal fistula extends above the insertion of the levator ani muscle. Supralevator fistulas extend upward in the intersphincteric plane and over the top of the levator ani and then descend through the ischiorectal and ischioanal fossae to reach the skin. The translevator fistulas extend directly from their origin in the pelvis to the perineal skin through the ischiorectal and ischioanal fossae with no involvement of the anal canal (<xref ref-type="fig" rid="poljradiol-79-490-g009">Figure 9</xref>).).']} | Our Experience with MR Imaging of Perianal Fistulas | [
"Classification",
"Magnetic Resonance Imaging",
"Rectal Fistula"
] | Pol J Radiol | 1419408000 | None | null | other | PMC4278700 | null | null | [
""
] | Pol J Radiol. 2014 Dec 24; 79:490-497 | NO-CC CODE |
|
SAG T2 MRI showing cervical spinal cord edema. | gr1_lrg | 7 | 0885d84ed826250d9b53166ff0b779c7856dbc8f8e615fbba00e82653b1ed801 | gr1_lrg.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
791,
642
] | [{'image_id': 'gr1_lrg', 'image_file_name': 'gr1_lrg.jpg', 'image_path': '../data/media_files/PMC8864811/gr1_lrg.jpg', 'caption': 'SAG T2 MRI showing cervical spinal cord edema.', 'hash': '0885d84ed826250d9b53166ff0b779c7856dbc8f8e615fbba00e82653b1ed801'}, {'image_id': 'gr2_lrg', 'image_file_name': 'gr2_lrg.jpg', 'image_path': '../data/media_files/PMC8864811/gr2_lrg.jpg', 'caption': 'SAG STIR fast IR MRI showing thoracic spinal cord edema.', 'hash': 'ce0b8710550a0f8709b631713de78af453b288524ec925469421a8ccff04b0be'}] | {'gr1_lrg': ['Approximately 12 h after the initial ED presentation, the patient reported worsening paresthesias and weakness. Repeat exam revealed complete loss of sensation in her lower extremities and severely limited range of motion in her hips, knees, and ankle joints. She had positive proprioception but diminished reflexes bilaterally in her lower extremities. She requested a foley catheter because she could not initiate urination. Magnetic resonance imaging (MRI) of the spine revealed diffusely abnormal signal and central cord edema of the majority of the spinal cord extending from approximately the C5-C6 level through the T11-T12 level. There was cord expansion as well as ill-defined associated enhancement. (See <xref rid="gr1_lrg" ref-type="fig">Fig. 1</xref>, , <xref rid="gr2_lrg" ref-type="fig">Fig. 2</xref>.)\n. The radiologist reported that given the patient\'s recent history of COVID-19 infection, the findings are most consistent with an extensive viral transverse myelitis..)\n. The radiologist reported that given the patient\'s recent history of COVID-19 infection, the findings are most consistent with an extensive viral transverse myelitis.Fig. 1SAG T2 MRI showing cervical spinal cord edema.Fig. 1Fig. 2SAG STIR fast IR MRI showing thoracic spinal cord edema.Fig. 2']} | Acute transverse myelitis progressing to permanent quadriplegia following COVID-19 infection | [
"COVID-19",
"Transverse myelitis",
"Quadraplegia"
] | Am J Emerg Med | 1655967600 | Currently, the world faces a novel coronavirus disease 2019 (COVID-19) challenge and infected cases are increasing exponentially. COVID-19 is a disease that has been reported by the WHO in March 2020, caused by a virus called the SARS-CoV-2. As of 10 March 2021, more than 150 million people were infected and 3v million died. Researchers strive to find out about the virus and recommend effective actions. An unprecedented increase in pathogens is happening and a major attempt is being made to tackle the epidemic. This article presents deep learning-based COVID-19 detection using CT and X-ray images and data analytics on its spread worldwide. This article's research structure builds on a recent analysis of the COVID-19 data and prospective research to systematize current resources, help the researchers, practitioners by using in-depth learning methodologies to build solutions for the COVID-19 pandemic. | [] | other | PMC8864811 | null | 24 | [
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"{'Citation': 'Worldometer. Accessed: 10/05/2021. COVID-19 Coronavirus Pandemic. [Online]. Available: https://www.worldometers.info/coronavirus/?'}",
"{'Citation': 'Business Insider. Accessed: 18/04/2020. Coronavirus-cases-maps-us-world-spread-symptoms-death-rate-2020. [Online]. Available: https://www.businessinsider.com/coronavirus-cases-maps-us-world-spread-symptoms-death-rate-2020-1#where-has-the-coronavirus-spread-1'}",
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] | Am J Emerg Med. 2022 Jun 23; 56:391.e1-391.e3 | NO-CC CODE |
|
Male, 40 years. A history of travel to Wuhan in the last 2 weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seen | 42058_2020_31_Fig8_HTML | 7 | 453e11dbf21a38f85a6e8674e18595fa8c7fc07360923cb86184431c4a697580 | 42058_2020_31_Fig8_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
646,
266
] | [{'image_id': '42058_2020_31_Fig14_HTML', 'image_file_name': '42058_2020_31_Fig14_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig14_HTML.jpg', 'caption': 'Male, 65\xa0years. No epidemiological history, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated ESR and LDH. CT shows subpleural GGO with AB sign, thickening of intralobular septa (crazy-paving sign) and thickening of small vessels', 'hash': '1f4bff445a8074e6114e0b79bb7f63acbcc923502de1b80691f5ef734cfaff65'}, {'image_id': '42058_2020_31_Fig2_HTML', 'image_file_name': '42058_2020_31_Fig2_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig2_HTML.jpg', 'caption': 'Female, 34\xa0years. Close contact with confirmed case, fever, cough, short breath, decreased WBC and lymphocyte count. CT shows subpleural consolidation and ill-defined nodule in the posterior basal segment of left lower lobe', 'hash': 'de58d01ab18796131e22d133f7a12fbef71926f39ed2b83b8011a32ac843068d'}, {'image_id': '42058_2020_31_Fig5_HTML', 'image_file_name': '42058_2020_31_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig5_HTML.jpg', 'caption': 'Male, 68\xa0years. Cluster transmission, fever, cough, normal WBC, decreased lymphocyte count, and elevated CRP. CT shows multiple GGO with peribronchovascular distribution and sparing the pleural surface', 'hash': '0acd738b93359bc0bd512d936b91a3c953efb32b062161833c96cefd0f0396e6'}, {'image_id': '42058_2020_31_Fig13_HTML', 'image_file_name': '42058_2020_31_Fig13_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig13_HTML.jpg', 'caption': 'Female, 21\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, runny nose and diarrhea, decreased WBC and lymphocyte count, elevated CRP. CT shows multiple small patchy GGO with ill-defined margin', 'hash': '43ff20c1d44780468caab74ab269920c9b392829849a8f1c42de1c5a132b5584'}, {'image_id': '42058_2020_31_Fig15_HTML', 'image_file_name': '42058_2020_31_Fig15_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig15_HTML.jpg', 'caption': 'Male, 42\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, and runny nose, normal WBC, decreased lymphocyte count, elevated CRP. CT shows GGO with AB sign and thickening of small vessels', 'hash': 'c0791a579daadf39f78be99966fef09aeae14b433bdf60da2a2be3f4efd79751'}, {'image_id': '42058_2020_31_Fig3_HTML', 'image_file_name': '42058_2020_31_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig3_HTML.jpg', 'caption': 'Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, multiple and subpleural GGO and consolidation', 'hash': '45f3bd62bc6af1c28e0b1b5036796d60e67e059f9e8a9372de35f4481dc49444'}, {'image_id': '42058_2020_31_Fig4_HTML', 'image_file_name': '42058_2020_31_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig4_HTML.jpg', 'caption': 'Male, 66\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP and LDH. CT shows multiple GGO with subpleural and peribronchovascular distribution, involvement of the inner zone of right middle lobe', 'hash': '79c2e0ca5187138d026101db8a1f7ada113652305dcc051240ed517fb104e8e0'}, {'image_id': '42058_2020_31_Fig12_HTML', 'image_file_name': '42058_2020_31_Fig12_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig12_HTML.jpg', 'caption': 'Male, 25\xa0years. A history of travel to Vietnam, fever, cough, normal WBC, decreased lymphocyte count and elevated CRP. CT shows consolidation surrounded by the GGO (halo sign) in the left upper lobe', 'hash': '596d2a7ede6911fe6f4a1271efda703ef2d94a6d843cdf1021f04a4fee95c1a9'}, {'image_id': '42058_2020_31_Fig7_HTML', 'image_file_name': '42058_2020_31_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig7_HTML.jpg', 'caption': 'Male, 41\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC lymphocyte count, elevated CRP. CT shows multiple consolidation, GGO, and AB sign', 'hash': 'f9327c25217534f7190774e11508f38435d876d4127b6a8c58b448d3e88afdb6'}, {'image_id': '42058_2020_31_Fig8_HTML', 'image_file_name': '42058_2020_31_Fig8_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig8_HTML.jpg', 'caption': 'Male, 40\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seen', 'hash': '453e11dbf21a38f85a6e8674e18595fa8c7fc07360923cb86184431c4a697580'}, {'image_id': '42058_2020_31_Fig11_HTML', 'image_file_name': '42058_2020_31_Fig11_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig11_HTML.jpg', 'caption': 'Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, round GGO with AB sign', 'hash': '7ccf087b21915ea91b9c78fc440d92f906ee8340615480798b78152d985bf3d1'}, {'image_id': '42058_2020_31_Fig16_HTML', 'image_file_name': '42058_2020_31_Fig16_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig16_HTML.jpg', 'caption': 'Male, 33\xa0years. A history of close contact with the fever person from Wuhan, fever, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows GGO and thickening of small vessels with natural course in the right lower lobe', 'hash': '034f27187de7a45dcfe8feeedc81b9123a5a58c5d7a364671602d9fa564a1d18'}, {'image_id': '42058_2020_31_Fig19_HTML', 'image_file_name': '42058_2020_31_Fig19_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig19_HTML.jpg', 'caption': 'Female, 62\xa0years. From Wuhan, fever for 5\xa0days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3\xa0days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16\xa0days later showed consolidation and GGO were resolved instead of fibrous strips', 'hash': 'ece931bb797ffe59941ed3bad9d74a08df780e1a801bd864f52249e73772148b'}, {'image_id': '42058_2020_31_Fig9_HTML', 'image_file_name': '42058_2020_31_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig9_HTML.jpg', 'caption': 'Male, 29\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, sore throat, normal WBC and lymphocyte count. CT shows multiple centrilobular nodules, thickening of the adjacent small vessels, and cone-shape in the apical segment of right upper lobe', 'hash': '95b8a6eb80e17b669d76b683509ba58ddb8ccb843382c27153ce8156494f7796'}, {'image_id': '42058_2020_31_Fig6_HTML', 'image_file_name': '42058_2020_31_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig6_HTML.jpg', 'caption': 'Male, 50\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes', 'hash': '7ac04064427c806171e807f7e98a3f2918dce954710a8dd324f257cc7f180dc7'}, {'image_id': '42058_2020_31_Fig10_HTML', 'image_file_name': '42058_2020_31_Fig10_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig10_HTML.jpg', 'caption': 'Female, 58\xa0years. Close contact with confirmed case, fever, cough, nasal congestion, and runny nose. CT shows multiple subpleural GGO with thickening of small vessel, and cone-shape in the left upper lobe', 'hash': '25055ed88c10e27aed719c3f938a848da2102015b023839b4d4a7e80e99d10ee'}, {'image_id': '42058_2020_31_Fig20_HTML', 'image_file_name': '42058_2020_31_Fig20_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig20_HTML.jpg', 'caption': 'Female, 8\xa0years. Clustering occurrence, fever, pharyngalgia, normal WBC and decreased lymphocyte count, elevated CRP. CT showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 5\xa0days later showed the lesions were smaller in size and lighter in density', 'hash': 'a4e2ce77c309148c0534edea5d2d63bc29f4ed6d9ff562dd1c21fbbf4abe78e0'}, {'image_id': '42058_2020_31_Fig18_HTML', 'image_file_name': '42058_2020_31_Fig18_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig18_HTML.jpg', 'caption': 'Female, 38\xa0years. A history of close contact with the fever person from Wuhan, cough, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP and LDH. CT shows subpleural consolidation sparing the pleural surface in the right lower lobe', 'hash': 'bcb163ababd76faee5df30a3dcdcf1c8b3d154fed9de8f58141851f53faf19c0'}, {'image_id': '42058_2020_31_Fig17_HTML', 'image_file_name': '42058_2020_31_Fig17_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig17_HTML.jpg', 'caption': 'Male, 49\xa0years. Close contact with the confirmed case, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows multiple GGO with crazy-paving sign, thickening of small vessels and shifted bilateral oblique fissure', 'hash': '2a6ce28a001d31a17ca820be88cd6860c4789041b4796c8567c36a9ee28a5111'}, {'image_id': '42058_2020_31_Fig1_HTML', 'image_file_name': '42058_2020_31_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig1_HTML.jpg', 'caption': 'Male, 30\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, normal WBC, and decreased lymphocyte count. No abnormal findings were found on CT images', 'hash': '3d7cdcb4bfbfb512f1aa4d948c20e0bc15b2b739a9955ce575485aca569ee330'}] | {'42058_2020_31_Fig1_HTML': ['COVID-19 CT findings vary with the patient’s age, immunity status, disease stage, underlying diseases and drug interventions at the time of scanning [6]. In the largest cohort (n\u2009=\u20091099) study by Guan et al. [3], 23.6% confirmed cases with CT scanning (n\u2009=\u2009840) showed no pneumonia on CT images (Fig.\xa0<xref rid="42058_2020_31_Fig1_HTML" ref-type="fig">1</xref>).).Fig. 1Male, 30\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, normal WBC, and decreased lymphocyte count. No abnormal findings were found on CT images'], '42058_2020_31_Fig2_HTML': ['The distribution of the pulmonary disease depends on the pathogenesis. The most frequent distribution is subpleural or peripheral area (86%, 44/51) [18] (Figs.\xa0<xref rid="42058_2020_31_Fig2_HTML" ref-type="fig">2</xref>, , <xref rid="42058_2020_31_Fig3_HTML" ref-type="fig">3</xref>). Moreover, the lower lobe (53%) and posterior lung (89%) is more prone to be involved [). Moreover, the lower lobe (53%) and posterior lung (89%) is more prone to be involved [19]. Occasionally, inner zone of lung can be affected (Fig.\xa0<xref rid="42058_2020_31_Fig4_HTML" ref-type="fig">4</xref>). Peri-bronchovascular bundle thickening can be found (Fig.\xa0). Peri-bronchovascular bundle thickening can be found (Fig.\xa0<xref rid="42058_2020_31_Fig5_HTML" ref-type="fig">5</xref>).).Fig. 2Female, 34\xa0years. Close contact with confirmed case, fever, cough, short breath, decreased WBC and lymphocyte count. CT shows subpleural consolidation and ill-defined nodule in the posterior basal segment of left lower lobeFig. 3Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, multiple and subpleural GGO and consolidationFig. 4Male, 66\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP and LDH. CT shows multiple GGO with subpleural and peribronchovascular distribution, involvement of the inner zone of right middle lobeFig. 5Male, 68\xa0years. Cluster transmission, fever, cough, normal WBC, decreased lymphocyte count, and elevated CRP. CT shows multiple GGO with peribronchovascular distribution and sparing the pleural surface'], '42058_2020_31_Fig6_HTML': ['Some cases show uni-focal lesion as the initial CT finding, then multifocal with the disease progression; while some show multifocal lesions at onset. 71% (15/21) patients had involvement of at least two lobes [20]; 63% (32/51) patients involved four to five lobes [19] (Fig.\xa0<xref rid="42058_2020_31_Fig6_HTML" ref-type="fig">6</xref>).).Fig. 6Male, 50\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes'], '42058_2020_31_Fig7_HTML': ['The density of lesion is usually heterogeneous. GGO is the most common imaging feature, presenting in about 50% (550/1099) cases. Consolidation (37.2%, 409/1099) [3], GGO with consolidation (59%, 30/51) [19], and fibrosis [12] can occur in severe type cases (Fig.\xa0<xref rid="42058_2020_31_Fig7_HTML" ref-type="fig">7</xref>). The first pathological findings of COVID-19 by postmortem biopsy showed the bilateral diffuse alveolar damage with cellular fibromyxoid exudate, which is the basis of GGO and consolidation [). The first pathological findings of COVID-19 by postmortem biopsy showed the bilateral diffuse alveolar damage with cellular fibromyxoid exudate, which is the basis of GGO and consolidation [21].Fig. 7Male, 41\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC lymphocyte count, elevated CRP. CT shows multiple consolidation, GGO, and AB sign'], '42058_2020_31_Fig8_HTML': ['The shape is related to the distribution pattern. Common shapes include patchy, cone-shape or triangle, subsegmental, and segmental. Sometimes, round or centrilobular nodule with halo sign [17] or reversed halo sign [18] also can be seen. The interface between lesion and the normal pulmonary is often ill-defined. Occasionally, the mosaic perfusion may be present (Figs.\xa0<xref rid="42058_2020_31_Fig8_HTML" ref-type="fig">8</xref>, , <xref rid="42058_2020_31_Fig9_HTML" ref-type="fig">9</xref>, , <xref rid="42058_2020_31_Fig10_HTML" ref-type="fig">10</xref>, , <xref rid="42058_2020_31_Fig11_HTML" ref-type="fig">11</xref>, , <xref rid="42058_2020_31_Fig12_HTML" ref-type="fig">12</xref>, , <xref rid="42058_2020_31_Fig13_HTML" ref-type="fig">13</xref>). Halo sign is defined as a circle of GGO surrounding a soft tissue density lung nodule, may be seen in some patients with a solitary pulmonary nodule. The histologic nature of halo varies with the disease, such as the hemorrhage, and lipid spread of tumor. The halo sign in patients with COVID-19 may be caused by the alveolar edema and hemorrhage. While reversed-halo sign may be related to the organization and resolution of alveolar exudates.). Halo sign is defined as a circle of GGO surrounding a soft tissue density lung nodule, may be seen in some patients with a solitary pulmonary nodule. The histologic nature of halo varies with the disease, such as the hemorrhage, and lipid spread of tumor. The halo sign in patients with COVID-19 may be caused by the alveolar edema and hemorrhage. While reversed-halo sign may be related to the organization and resolution of alveolar exudates.Fig. 8Male, 40\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seenFig. 9Male, 29\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, sore throat, normal WBC and lymphocyte count. CT shows multiple centrilobular nodules, thickening of the adjacent small vessels, and cone-shape in the apical segment of right upper lobeFig. 10Female, 58\xa0years. Close contact with confirmed case, fever, cough, nasal congestion, and runny nose. CT shows multiple subpleural GGO with thickening of small vessel, and cone-shape in the left upper lobeFig. 11Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, round GGO with AB signFig. 12Male, 25\xa0years. A history of travel to Vietnam, fever, cough, normal WBC, decreased lymphocyte count and elevated CRP. CT shows consolidation surrounded by the GGO (halo sign) in the left upper lobeFig. 13Female, 21\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, runny nose and diarrhea, decreased WBC and lymphocyte count, elevated CRP. CT shows multiple small patchy GGO with ill-defined margin'], '42058_2020_31_Fig14_HTML': ['The typical and most common internal features are ‘crazy-paving’ sign (GGO superimposed the thickening of interlobular or intralobular septa), thickening of small vessels with natural course, and air bronchogram (AB) (80%, 41/51). Sometimes, bronchovascular bundle is thickened within the lesion. Cavity can occur in occasion [16] (Figs.\xa0<xref rid="42058_2020_31_Fig14_HTML" ref-type="fig">14</xref>, , <xref rid="42058_2020_31_Fig15_HTML" ref-type="fig">15</xref>, , <xref rid="42058_2020_31_Fig16_HTML" ref-type="fig">16</xref>).).Fig. 14Male, 65\xa0years. No epidemiological history, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated ESR and LDH. CT shows subpleural GGO with AB sign, thickening of intralobular septa (crazy-paving sign) and thickening of small vesselsFig. 15Male, 42\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, and runny nose, normal WBC, decreased lymphocyte count, elevated CRP. CT shows GGO with AB sign and thickening of small vesselsFig. 16Male, 33\xa0years. A history of close contact with the fever person from Wuhan, fever, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows GGO and thickening of small vessels with natural course in the right lower lobe'], '42058_2020_31_Fig17_HTML': ['The common changes of adjacent structures include the thickening and/or shifting of pleural (Fig.\xa0<xref rid="42058_2020_31_Fig17_HTML" ref-type="fig">17</xref>). The subpleural region may be spared (Fig.\xa0). The subpleural region may be spared (Fig.\xa0<xref rid="42058_2020_31_Fig18_HTML" ref-type="fig">18</xref>) or not [) or not [22], speculating related to the amount of alveolar exudates and the distance to the pleural. Pleural effusion, pericardial effusion and lymphadenopathy are rare.Fig. 17Male, 49\xa0years. Close contact with the confirmed case, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows multiple GGO with crazy-paving sign, thickening of small vessels and shifted bilateral oblique fissureFig. 18Female, 38\xa0years. A history of close contact with the fever person from Wuhan, cough, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP and LDH. CT shows subpleural consolidation sparing the pleural surface in the right lower lobe'], '42058_2020_31_Fig19_HTML': ['The evolution process of COVID-19 on CT image is not quite clear yet. Feng et al. [23] reviewed 21 patients recovering from COVID-19 (without severe respiratory distress during the disease course). The mean interval between baseline and follow-up CT scans was 4\u2009±\u20091\xa0days, and the mean hospitalization duration was 17\u2009±\u20094\xa0days. The majority of cases with COVID-19 were controlled with stable and improving conditions after effective personalized treatment. The peak severity was at approximately 10\xa0days and the improvement happened at approximately 14\xa0days after initial onset of symptoms. The follow-up CT showed that the lesions in lungs were decreased in both number and size. The density of lesions was reduced as well [12, 24]. The CT findings of clinically cured cases showed full recovery or only small amounts of residual stripes (Fig.\xa0<xref rid="42058_2020_31_Fig19_HTML" ref-type="fig">19</xref>). For some cases, the GGO and consolidation in lungs became some thick fibrotic stripes in short term, which need follow-up studies to explore its final outcome.). For some cases, the GGO and consolidation in lungs became some thick fibrotic stripes in short term, which need follow-up studies to explore its final outcome.Fig. 19Female, 62\xa0years. From Wuhan, fever for 5\xa0days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3\xa0days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16\xa0days later showed consolidation and GGO were resolved instead of fibrous strips'], '42058_2020_31_Fig20_HTML': ['Chest X-ray may show no abnormality, therefore it is not recommended as a screening tool in children. CT findings of COVID-19 in children were variable and non-specific. The GGO and consolidation were also the most common findings in bilateral lungs, while the lesions in children were less diffused than adults [25]. One relative specific CT characteristics in children was the presentation mimic bronchopneumonia. Pleural effusion and lymphadenopathy were also not observed (Fig.\xa0<xref rid="42058_2020_31_Fig20_HTML" ref-type="fig">20</xref>).).Fig. 20Female, 8\xa0years. Clustering occurrence, fever, pharyngalgia, normal WBC and decreased lymphocyte count, elevated CRP. CT showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 5\xa0days later showed the lesions were smaller in size and lighter in density']} | Progress and prospect on imaging diagnosis of COVID-19 | [
"COVID-19",
"Imaging",
"Viral pneumonia",
"Artificial intelligence"
] | Chin J Acad Radiol | 1584514800 | None | null | other | PMC7149076 | null | null | [
""
] | Chin J Acad Radiol. 2020 Mar 18; 3(1):4-13 | NO-CC CODE |
|
Female, 62 years. From Wuhan, fever for 5 days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3 days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16 days later showed consolidation and GGO were resolved instead of fibrous strips | 42058_2020_31_Fig19_HTML | 7 | ece931bb797ffe59941ed3bad9d74a08df780e1a801bd864f52249e73772148b | 42058_2020_31_Fig19_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
750,
195
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CT shows subpleural consolidation and ill-defined nodule in the posterior basal segment of left lower lobe', 'hash': 'de58d01ab18796131e22d133f7a12fbef71926f39ed2b83b8011a32ac843068d'}, {'image_id': '42058_2020_31_Fig5_HTML', 'image_file_name': '42058_2020_31_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig5_HTML.jpg', 'caption': 'Male, 68\xa0years. Cluster transmission, fever, cough, normal WBC, decreased lymphocyte count, and elevated CRP. CT shows multiple GGO with peribronchovascular distribution and sparing the pleural surface', 'hash': '0acd738b93359bc0bd512d936b91a3c953efb32b062161833c96cefd0f0396e6'}, {'image_id': '42058_2020_31_Fig13_HTML', 'image_file_name': '42058_2020_31_Fig13_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig13_HTML.jpg', 'caption': 'Female, 21\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, runny nose and diarrhea, decreased WBC and lymphocyte count, elevated CRP. CT shows multiple small patchy GGO with ill-defined margin', 'hash': '43ff20c1d44780468caab74ab269920c9b392829849a8f1c42de1c5a132b5584'}, {'image_id': '42058_2020_31_Fig15_HTML', 'image_file_name': '42058_2020_31_Fig15_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig15_HTML.jpg', 'caption': 'Male, 42\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, and runny nose, normal WBC, decreased lymphocyte count, elevated CRP. CT shows GGO with AB sign and thickening of small vessels', 'hash': 'c0791a579daadf39f78be99966fef09aeae14b433bdf60da2a2be3f4efd79751'}, {'image_id': '42058_2020_31_Fig3_HTML', 'image_file_name': '42058_2020_31_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig3_HTML.jpg', 'caption': 'Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, multiple and subpleural GGO and consolidation', 'hash': '45f3bd62bc6af1c28e0b1b5036796d60e67e059f9e8a9372de35f4481dc49444'}, {'image_id': '42058_2020_31_Fig4_HTML', 'image_file_name': '42058_2020_31_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig4_HTML.jpg', 'caption': 'Male, 66\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP and LDH. CT shows multiple GGO with subpleural and peribronchovascular distribution, involvement of the inner zone of right middle lobe', 'hash': '79c2e0ca5187138d026101db8a1f7ada113652305dcc051240ed517fb104e8e0'}, {'image_id': '42058_2020_31_Fig12_HTML', 'image_file_name': '42058_2020_31_Fig12_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig12_HTML.jpg', 'caption': 'Male, 25\xa0years. A history of travel to Vietnam, fever, cough, normal WBC, decreased lymphocyte count and elevated CRP. CT shows consolidation surrounded by the GGO (halo sign) in the left upper lobe', 'hash': '596d2a7ede6911fe6f4a1271efda703ef2d94a6d843cdf1021f04a4fee95c1a9'}, {'image_id': '42058_2020_31_Fig7_HTML', 'image_file_name': '42058_2020_31_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig7_HTML.jpg', 'caption': 'Male, 41\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC lymphocyte count, elevated CRP. CT shows multiple consolidation, GGO, and AB sign', 'hash': 'f9327c25217534f7190774e11508f38435d876d4127b6a8c58b448d3e88afdb6'}, {'image_id': '42058_2020_31_Fig8_HTML', 'image_file_name': '42058_2020_31_Fig8_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig8_HTML.jpg', 'caption': 'Male, 40\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seen', 'hash': '453e11dbf21a38f85a6e8674e18595fa8c7fc07360923cb86184431c4a697580'}, {'image_id': '42058_2020_31_Fig11_HTML', 'image_file_name': '42058_2020_31_Fig11_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig11_HTML.jpg', 'caption': 'Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, round GGO with AB sign', 'hash': '7ccf087b21915ea91b9c78fc440d92f906ee8340615480798b78152d985bf3d1'}, {'image_id': '42058_2020_31_Fig16_HTML', 'image_file_name': '42058_2020_31_Fig16_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig16_HTML.jpg', 'caption': 'Male, 33\xa0years. A history of close contact with the fever person from Wuhan, fever, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows GGO and thickening of small vessels with natural course in the right lower lobe', 'hash': '034f27187de7a45dcfe8feeedc81b9123a5a58c5d7a364671602d9fa564a1d18'}, {'image_id': '42058_2020_31_Fig19_HTML', 'image_file_name': '42058_2020_31_Fig19_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig19_HTML.jpg', 'caption': 'Female, 62\xa0years. From Wuhan, fever for 5\xa0days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3\xa0days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16\xa0days later showed consolidation and GGO were resolved instead of fibrous strips', 'hash': 'ece931bb797ffe59941ed3bad9d74a08df780e1a801bd864f52249e73772148b'}, {'image_id': '42058_2020_31_Fig9_HTML', 'image_file_name': '42058_2020_31_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig9_HTML.jpg', 'caption': 'Male, 29\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, sore throat, normal WBC and lymphocyte count. CT shows multiple centrilobular nodules, thickening of the adjacent small vessels, and cone-shape in the apical segment of right upper lobe', 'hash': '95b8a6eb80e17b669d76b683509ba58ddb8ccb843382c27153ce8156494f7796'}, {'image_id': '42058_2020_31_Fig6_HTML', 'image_file_name': '42058_2020_31_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig6_HTML.jpg', 'caption': 'Male, 50\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes', 'hash': '7ac04064427c806171e807f7e98a3f2918dce954710a8dd324f257cc7f180dc7'}, {'image_id': '42058_2020_31_Fig10_HTML', 'image_file_name': '42058_2020_31_Fig10_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig10_HTML.jpg', 'caption': 'Female, 58\xa0years. Close contact with confirmed case, fever, cough, nasal congestion, and runny nose. CT shows multiple subpleural GGO with thickening of small vessel, and cone-shape in the left upper lobe', 'hash': '25055ed88c10e27aed719c3f938a848da2102015b023839b4d4a7e80e99d10ee'}, {'image_id': '42058_2020_31_Fig20_HTML', 'image_file_name': '42058_2020_31_Fig20_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig20_HTML.jpg', 'caption': 'Female, 8\xa0years. Clustering occurrence, fever, pharyngalgia, normal WBC and decreased lymphocyte count, elevated CRP. CT showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 5\xa0days later showed the lesions were smaller in size and lighter in density', 'hash': 'a4e2ce77c309148c0534edea5d2d63bc29f4ed6d9ff562dd1c21fbbf4abe78e0'}, {'image_id': '42058_2020_31_Fig18_HTML', 'image_file_name': '42058_2020_31_Fig18_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig18_HTML.jpg', 'caption': 'Female, 38\xa0years. A history of close contact with the fever person from Wuhan, cough, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP and LDH. CT shows subpleural consolidation sparing the pleural surface in the right lower lobe', 'hash': 'bcb163ababd76faee5df30a3dcdcf1c8b3d154fed9de8f58141851f53faf19c0'}, {'image_id': '42058_2020_31_Fig17_HTML', 'image_file_name': '42058_2020_31_Fig17_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig17_HTML.jpg', 'caption': 'Male, 49\xa0years. Close contact with the confirmed case, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows multiple GGO with crazy-paving sign, thickening of small vessels and shifted bilateral oblique fissure', 'hash': '2a6ce28a001d31a17ca820be88cd6860c4789041b4796c8567c36a9ee28a5111'}, {'image_id': '42058_2020_31_Fig1_HTML', 'image_file_name': '42058_2020_31_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig1_HTML.jpg', 'caption': 'Male, 30\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, normal WBC, and decreased lymphocyte count. No abnormal findings were found on CT images', 'hash': '3d7cdcb4bfbfb512f1aa4d948c20e0bc15b2b739a9955ce575485aca569ee330'}] | {'42058_2020_31_Fig1_HTML': ['COVID-19 CT findings vary with the patient’s age, immunity status, disease stage, underlying diseases and drug interventions at the time of scanning [6]. In the largest cohort (n\u2009=\u20091099) study by Guan et al. [3], 23.6% confirmed cases with CT scanning (n\u2009=\u2009840) showed no pneumonia on CT images (Fig.\xa0<xref rid="42058_2020_31_Fig1_HTML" ref-type="fig">1</xref>).).Fig. 1Male, 30\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, normal WBC, and decreased lymphocyte count. No abnormal findings were found on CT images'], '42058_2020_31_Fig2_HTML': ['The distribution of the pulmonary disease depends on the pathogenesis. The most frequent distribution is subpleural or peripheral area (86%, 44/51) [18] (Figs.\xa0<xref rid="42058_2020_31_Fig2_HTML" ref-type="fig">2</xref>, , <xref rid="42058_2020_31_Fig3_HTML" ref-type="fig">3</xref>). Moreover, the lower lobe (53%) and posterior lung (89%) is more prone to be involved [). Moreover, the lower lobe (53%) and posterior lung (89%) is more prone to be involved [19]. Occasionally, inner zone of lung can be affected (Fig.\xa0<xref rid="42058_2020_31_Fig4_HTML" ref-type="fig">4</xref>). Peri-bronchovascular bundle thickening can be found (Fig.\xa0). Peri-bronchovascular bundle thickening can be found (Fig.\xa0<xref rid="42058_2020_31_Fig5_HTML" ref-type="fig">5</xref>).).Fig. 2Female, 34\xa0years. Close contact with confirmed case, fever, cough, short breath, decreased WBC and lymphocyte count. CT shows subpleural consolidation and ill-defined nodule in the posterior basal segment of left lower lobeFig. 3Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, multiple and subpleural GGO and consolidationFig. 4Male, 66\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP and LDH. CT shows multiple GGO with subpleural and peribronchovascular distribution, involvement of the inner zone of right middle lobeFig. 5Male, 68\xa0years. Cluster transmission, fever, cough, normal WBC, decreased lymphocyte count, and elevated CRP. CT shows multiple GGO with peribronchovascular distribution and sparing the pleural surface'], '42058_2020_31_Fig6_HTML': ['Some cases show uni-focal lesion as the initial CT finding, then multifocal with the disease progression; while some show multifocal lesions at onset. 71% (15/21) patients had involvement of at least two lobes [20]; 63% (32/51) patients involved four to five lobes [19] (Fig.\xa0<xref rid="42058_2020_31_Fig6_HTML" ref-type="fig">6</xref>).).Fig. 6Male, 50\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes'], '42058_2020_31_Fig7_HTML': ['The density of lesion is usually heterogeneous. GGO is the most common imaging feature, presenting in about 50% (550/1099) cases. Consolidation (37.2%, 409/1099) [3], GGO with consolidation (59%, 30/51) [19], and fibrosis [12] can occur in severe type cases (Fig.\xa0<xref rid="42058_2020_31_Fig7_HTML" ref-type="fig">7</xref>). The first pathological findings of COVID-19 by postmortem biopsy showed the bilateral diffuse alveolar damage with cellular fibromyxoid exudate, which is the basis of GGO and consolidation [). The first pathological findings of COVID-19 by postmortem biopsy showed the bilateral diffuse alveolar damage with cellular fibromyxoid exudate, which is the basis of GGO and consolidation [21].Fig. 7Male, 41\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC lymphocyte count, elevated CRP. CT shows multiple consolidation, GGO, and AB sign'], '42058_2020_31_Fig8_HTML': ['The shape is related to the distribution pattern. Common shapes include patchy, cone-shape or triangle, subsegmental, and segmental. Sometimes, round or centrilobular nodule with halo sign [17] or reversed halo sign [18] also can be seen. The interface between lesion and the normal pulmonary is often ill-defined. Occasionally, the mosaic perfusion may be present (Figs.\xa0<xref rid="42058_2020_31_Fig8_HTML" ref-type="fig">8</xref>, , <xref rid="42058_2020_31_Fig9_HTML" ref-type="fig">9</xref>, , <xref rid="42058_2020_31_Fig10_HTML" ref-type="fig">10</xref>, , <xref rid="42058_2020_31_Fig11_HTML" ref-type="fig">11</xref>, , <xref rid="42058_2020_31_Fig12_HTML" ref-type="fig">12</xref>, , <xref rid="42058_2020_31_Fig13_HTML" ref-type="fig">13</xref>). Halo sign is defined as a circle of GGO surrounding a soft tissue density lung nodule, may be seen in some patients with a solitary pulmonary nodule. The histologic nature of halo varies with the disease, such as the hemorrhage, and lipid spread of tumor. The halo sign in patients with COVID-19 may be caused by the alveolar edema and hemorrhage. While reversed-halo sign may be related to the organization and resolution of alveolar exudates.). Halo sign is defined as a circle of GGO surrounding a soft tissue density lung nodule, may be seen in some patients with a solitary pulmonary nodule. The histologic nature of halo varies with the disease, such as the hemorrhage, and lipid spread of tumor. The halo sign in patients with COVID-19 may be caused by the alveolar edema and hemorrhage. While reversed-halo sign may be related to the organization and resolution of alveolar exudates.Fig. 8Male, 40\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seenFig. 9Male, 29\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, sore throat, normal WBC and lymphocyte count. CT shows multiple centrilobular nodules, thickening of the adjacent small vessels, and cone-shape in the apical segment of right upper lobeFig. 10Female, 58\xa0years. Close contact with confirmed case, fever, cough, nasal congestion, and runny nose. CT shows multiple subpleural GGO with thickening of small vessel, and cone-shape in the left upper lobeFig. 11Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, round GGO with AB signFig. 12Male, 25\xa0years. A history of travel to Vietnam, fever, cough, normal WBC, decreased lymphocyte count and elevated CRP. CT shows consolidation surrounded by the GGO (halo sign) in the left upper lobeFig. 13Female, 21\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, runny nose and diarrhea, decreased WBC and lymphocyte count, elevated CRP. CT shows multiple small patchy GGO with ill-defined margin'], '42058_2020_31_Fig14_HTML': ['The typical and most common internal features are ‘crazy-paving’ sign (GGO superimposed the thickening of interlobular or intralobular septa), thickening of small vessels with natural course, and air bronchogram (AB) (80%, 41/51). Sometimes, bronchovascular bundle is thickened within the lesion. Cavity can occur in occasion [16] (Figs.\xa0<xref rid="42058_2020_31_Fig14_HTML" ref-type="fig">14</xref>, , <xref rid="42058_2020_31_Fig15_HTML" ref-type="fig">15</xref>, , <xref rid="42058_2020_31_Fig16_HTML" ref-type="fig">16</xref>).).Fig. 14Male, 65\xa0years. No epidemiological history, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated ESR and LDH. CT shows subpleural GGO with AB sign, thickening of intralobular septa (crazy-paving sign) and thickening of small vesselsFig. 15Male, 42\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, and runny nose, normal WBC, decreased lymphocyte count, elevated CRP. CT shows GGO with AB sign and thickening of small vesselsFig. 16Male, 33\xa0years. A history of close contact with the fever person from Wuhan, fever, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows GGO and thickening of small vessels with natural course in the right lower lobe'], '42058_2020_31_Fig17_HTML': ['The common changes of adjacent structures include the thickening and/or shifting of pleural (Fig.\xa0<xref rid="42058_2020_31_Fig17_HTML" ref-type="fig">17</xref>). The subpleural region may be spared (Fig.\xa0). The subpleural region may be spared (Fig.\xa0<xref rid="42058_2020_31_Fig18_HTML" ref-type="fig">18</xref>) or not [) or not [22], speculating related to the amount of alveolar exudates and the distance to the pleural. Pleural effusion, pericardial effusion and lymphadenopathy are rare.Fig. 17Male, 49\xa0years. Close contact with the confirmed case, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows multiple GGO with crazy-paving sign, thickening of small vessels and shifted bilateral oblique fissureFig. 18Female, 38\xa0years. A history of close contact with the fever person from Wuhan, cough, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP and LDH. CT shows subpleural consolidation sparing the pleural surface in the right lower lobe'], '42058_2020_31_Fig19_HTML': ['The evolution process of COVID-19 on CT image is not quite clear yet. Feng et al. [23] reviewed 21 patients recovering from COVID-19 (without severe respiratory distress during the disease course). The mean interval between baseline and follow-up CT scans was 4\u2009±\u20091\xa0days, and the mean hospitalization duration was 17\u2009±\u20094\xa0days. The majority of cases with COVID-19 were controlled with stable and improving conditions after effective personalized treatment. The peak severity was at approximately 10\xa0days and the improvement happened at approximately 14\xa0days after initial onset of symptoms. The follow-up CT showed that the lesions in lungs were decreased in both number and size. The density of lesions was reduced as well [12, 24]. The CT findings of clinically cured cases showed full recovery or only small amounts of residual stripes (Fig.\xa0<xref rid="42058_2020_31_Fig19_HTML" ref-type="fig">19</xref>). For some cases, the GGO and consolidation in lungs became some thick fibrotic stripes in short term, which need follow-up studies to explore its final outcome.). For some cases, the GGO and consolidation in lungs became some thick fibrotic stripes in short term, which need follow-up studies to explore its final outcome.Fig. 19Female, 62\xa0years. From Wuhan, fever for 5\xa0days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3\xa0days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16\xa0days later showed consolidation and GGO were resolved instead of fibrous strips'], '42058_2020_31_Fig20_HTML': ['Chest X-ray may show no abnormality, therefore it is not recommended as a screening tool in children. CT findings of COVID-19 in children were variable and non-specific. The GGO and consolidation were also the most common findings in bilateral lungs, while the lesions in children were less diffused than adults [25]. One relative specific CT characteristics in children was the presentation mimic bronchopneumonia. Pleural effusion and lymphadenopathy were also not observed (Fig.\xa0<xref rid="42058_2020_31_Fig20_HTML" ref-type="fig">20</xref>).).Fig. 20Female, 8\xa0years. Clustering occurrence, fever, pharyngalgia, normal WBC and decreased lymphocyte count, elevated CRP. CT showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 5\xa0days later showed the lesions were smaller in size and lighter in density']} | Progress and prospect on imaging diagnosis of COVID-19 | [
"COVID-19",
"Imaging",
"Viral pneumonia",
"Artificial intelligence"
] | Chin J Acad Radiol | 1584514800 | None | null | other | PMC7149076 | null | null | [
""
] | Chin J Acad Radiol. 2020 Mar 18; 3(1):4-13 | NO-CC CODE |
|
Male, 50 years. A history of travel to Wuhan in the last 2 weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes | 42058_2020_31_Fig6_HTML | 7 | 7ac04064427c806171e807f7e98a3f2918dce954710a8dd324f257cc7f180dc7 | 42058_2020_31_Fig6_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
646,
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CT shows subpleural consolidation and ill-defined nodule in the posterior basal segment of left lower lobe', 'hash': 'de58d01ab18796131e22d133f7a12fbef71926f39ed2b83b8011a32ac843068d'}, {'image_id': '42058_2020_31_Fig5_HTML', 'image_file_name': '42058_2020_31_Fig5_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig5_HTML.jpg', 'caption': 'Male, 68\xa0years. Cluster transmission, fever, cough, normal WBC, decreased lymphocyte count, and elevated CRP. CT shows multiple GGO with peribronchovascular distribution and sparing the pleural surface', 'hash': '0acd738b93359bc0bd512d936b91a3c953efb32b062161833c96cefd0f0396e6'}, {'image_id': '42058_2020_31_Fig13_HTML', 'image_file_name': '42058_2020_31_Fig13_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig13_HTML.jpg', 'caption': 'Female, 21\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, runny nose and diarrhea, decreased WBC and lymphocyte count, elevated CRP. CT shows multiple small patchy GGO with ill-defined margin', 'hash': '43ff20c1d44780468caab74ab269920c9b392829849a8f1c42de1c5a132b5584'}, {'image_id': '42058_2020_31_Fig15_HTML', 'image_file_name': '42058_2020_31_Fig15_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig15_HTML.jpg', 'caption': 'Male, 42\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, and runny nose, normal WBC, decreased lymphocyte count, elevated CRP. CT shows GGO with AB sign and thickening of small vessels', 'hash': 'c0791a579daadf39f78be99966fef09aeae14b433bdf60da2a2be3f4efd79751'}, {'image_id': '42058_2020_31_Fig3_HTML', 'image_file_name': '42058_2020_31_Fig3_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig3_HTML.jpg', 'caption': 'Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, multiple and subpleural GGO and consolidation', 'hash': '45f3bd62bc6af1c28e0b1b5036796d60e67e059f9e8a9372de35f4481dc49444'}, {'image_id': '42058_2020_31_Fig4_HTML', 'image_file_name': '42058_2020_31_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig4_HTML.jpg', 'caption': 'Male, 66\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP and LDH. CT shows multiple GGO with subpleural and peribronchovascular distribution, involvement of the inner zone of right middle lobe', 'hash': '79c2e0ca5187138d026101db8a1f7ada113652305dcc051240ed517fb104e8e0'}, {'image_id': '42058_2020_31_Fig12_HTML', 'image_file_name': '42058_2020_31_Fig12_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig12_HTML.jpg', 'caption': 'Male, 25\xa0years. A history of travel to Vietnam, fever, cough, normal WBC, decreased lymphocyte count and elevated CRP. CT shows consolidation surrounded by the GGO (halo sign) in the left upper lobe', 'hash': '596d2a7ede6911fe6f4a1271efda703ef2d94a6d843cdf1021f04a4fee95c1a9'}, {'image_id': '42058_2020_31_Fig7_HTML', 'image_file_name': '42058_2020_31_Fig7_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig7_HTML.jpg', 'caption': 'Male, 41\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC lymphocyte count, elevated CRP. CT shows multiple consolidation, GGO, and AB sign', 'hash': 'f9327c25217534f7190774e11508f38435d876d4127b6a8c58b448d3e88afdb6'}, {'image_id': '42058_2020_31_Fig8_HTML', 'image_file_name': '42058_2020_31_Fig8_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig8_HTML.jpg', 'caption': 'Male, 40\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seen', 'hash': '453e11dbf21a38f85a6e8674e18595fa8c7fc07360923cb86184431c4a697580'}, {'image_id': '42058_2020_31_Fig11_HTML', 'image_file_name': '42058_2020_31_Fig11_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig11_HTML.jpg', 'caption': 'Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, round GGO with AB sign', 'hash': '7ccf087b21915ea91b9c78fc440d92f906ee8340615480798b78152d985bf3d1'}, {'image_id': '42058_2020_31_Fig16_HTML', 'image_file_name': '42058_2020_31_Fig16_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig16_HTML.jpg', 'caption': 'Male, 33\xa0years. A history of close contact with the fever person from Wuhan, fever, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows GGO and thickening of small vessels with natural course in the right lower lobe', 'hash': '034f27187de7a45dcfe8feeedc81b9123a5a58c5d7a364671602d9fa564a1d18'}, {'image_id': '42058_2020_31_Fig19_HTML', 'image_file_name': '42058_2020_31_Fig19_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig19_HTML.jpg', 'caption': 'Female, 62\xa0years. From Wuhan, fever for 5\xa0days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3\xa0days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16\xa0days later showed consolidation and GGO were resolved instead of fibrous strips', 'hash': 'ece931bb797ffe59941ed3bad9d74a08df780e1a801bd864f52249e73772148b'}, {'image_id': '42058_2020_31_Fig9_HTML', 'image_file_name': '42058_2020_31_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig9_HTML.jpg', 'caption': 'Male, 29\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, sore throat, normal WBC and lymphocyte count. CT shows multiple centrilobular nodules, thickening of the adjacent small vessels, and cone-shape in the apical segment of right upper lobe', 'hash': '95b8a6eb80e17b669d76b683509ba58ddb8ccb843382c27153ce8156494f7796'}, {'image_id': '42058_2020_31_Fig6_HTML', 'image_file_name': '42058_2020_31_Fig6_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig6_HTML.jpg', 'caption': 'Male, 50\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes', 'hash': '7ac04064427c806171e807f7e98a3f2918dce954710a8dd324f257cc7f180dc7'}, {'image_id': '42058_2020_31_Fig10_HTML', 'image_file_name': '42058_2020_31_Fig10_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig10_HTML.jpg', 'caption': 'Female, 58\xa0years. Close contact with confirmed case, fever, cough, nasal congestion, and runny nose. CT shows multiple subpleural GGO with thickening of small vessel, and cone-shape in the left upper lobe', 'hash': '25055ed88c10e27aed719c3f938a848da2102015b023839b4d4a7e80e99d10ee'}, {'image_id': '42058_2020_31_Fig20_HTML', 'image_file_name': '42058_2020_31_Fig20_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig20_HTML.jpg', 'caption': 'Female, 8\xa0years. Clustering occurrence, fever, pharyngalgia, normal WBC and decreased lymphocyte count, elevated CRP. CT showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 5\xa0days later showed the lesions were smaller in size and lighter in density', 'hash': 'a4e2ce77c309148c0534edea5d2d63bc29f4ed6d9ff562dd1c21fbbf4abe78e0'}, {'image_id': '42058_2020_31_Fig18_HTML', 'image_file_name': '42058_2020_31_Fig18_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig18_HTML.jpg', 'caption': 'Female, 38\xa0years. A history of close contact with the fever person from Wuhan, cough, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP and LDH. CT shows subpleural consolidation sparing the pleural surface in the right lower lobe', 'hash': 'bcb163ababd76faee5df30a3dcdcf1c8b3d154fed9de8f58141851f53faf19c0'}, {'image_id': '42058_2020_31_Fig17_HTML', 'image_file_name': '42058_2020_31_Fig17_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig17_HTML.jpg', 'caption': 'Male, 49\xa0years. Close contact with the confirmed case, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows multiple GGO with crazy-paving sign, thickening of small vessels and shifted bilateral oblique fissure', 'hash': '2a6ce28a001d31a17ca820be88cd6860c4789041b4796c8567c36a9ee28a5111'}, {'image_id': '42058_2020_31_Fig1_HTML', 'image_file_name': '42058_2020_31_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7149076/42058_2020_31_Fig1_HTML.jpg', 'caption': 'Male, 30\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, normal WBC, and decreased lymphocyte count. No abnormal findings were found on CT images', 'hash': '3d7cdcb4bfbfb512f1aa4d948c20e0bc15b2b739a9955ce575485aca569ee330'}] | {'42058_2020_31_Fig1_HTML': ['COVID-19 CT findings vary with the patient’s age, immunity status, disease stage, underlying diseases and drug interventions at the time of scanning [6]. In the largest cohort (n\u2009=\u20091099) study by Guan et al. [3], 23.6% confirmed cases with CT scanning (n\u2009=\u2009840) showed no pneumonia on CT images (Fig.\xa0<xref rid="42058_2020_31_Fig1_HTML" ref-type="fig">1</xref>).).Fig. 1Male, 30\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, normal WBC, and decreased lymphocyte count. No abnormal findings were found on CT images'], '42058_2020_31_Fig2_HTML': ['The distribution of the pulmonary disease depends on the pathogenesis. The most frequent distribution is subpleural or peripheral area (86%, 44/51) [18] (Figs.\xa0<xref rid="42058_2020_31_Fig2_HTML" ref-type="fig">2</xref>, , <xref rid="42058_2020_31_Fig3_HTML" ref-type="fig">3</xref>). Moreover, the lower lobe (53%) and posterior lung (89%) is more prone to be involved [). Moreover, the lower lobe (53%) and posterior lung (89%) is more prone to be involved [19]. Occasionally, inner zone of lung can be affected (Fig.\xa0<xref rid="42058_2020_31_Fig4_HTML" ref-type="fig">4</xref>). Peri-bronchovascular bundle thickening can be found (Fig.\xa0). Peri-bronchovascular bundle thickening can be found (Fig.\xa0<xref rid="42058_2020_31_Fig5_HTML" ref-type="fig">5</xref>).).Fig. 2Female, 34\xa0years. Close contact with confirmed case, fever, cough, short breath, decreased WBC and lymphocyte count. CT shows subpleural consolidation and ill-defined nodule in the posterior basal segment of left lower lobeFig. 3Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, multiple and subpleural GGO and consolidationFig. 4Male, 66\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP and LDH. CT shows multiple GGO with subpleural and peribronchovascular distribution, involvement of the inner zone of right middle lobeFig. 5Male, 68\xa0years. Cluster transmission, fever, cough, normal WBC, decreased lymphocyte count, and elevated CRP. CT shows multiple GGO with peribronchovascular distribution and sparing the pleural surface'], '42058_2020_31_Fig6_HTML': ['Some cases show uni-focal lesion as the initial CT finding, then multifocal with the disease progression; while some show multifocal lesions at onset. 71% (15/21) patients had involvement of at least two lobes [20]; 63% (32/51) patients involved four to five lobes [19] (Fig.\xa0<xref rid="42058_2020_31_Fig6_HTML" ref-type="fig">6</xref>).).Fig. 6Male, 50\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, short breath, hypoxemia, normal WBC, decreased lymphocyte count, and elevated CRP and LDH. CT shows multiple GGO involvement of five lobes'], '42058_2020_31_Fig7_HTML': ['The density of lesion is usually heterogeneous. GGO is the most common imaging feature, presenting in about 50% (550/1099) cases. Consolidation (37.2%, 409/1099) [3], GGO with consolidation (59%, 30/51) [19], and fibrosis [12] can occur in severe type cases (Fig.\xa0<xref rid="42058_2020_31_Fig7_HTML" ref-type="fig">7</xref>). The first pathological findings of COVID-19 by postmortem biopsy showed the bilateral diffuse alveolar damage with cellular fibromyxoid exudate, which is the basis of GGO and consolidation [). The first pathological findings of COVID-19 by postmortem biopsy showed the bilateral diffuse alveolar damage with cellular fibromyxoid exudate, which is the basis of GGO and consolidation [21].Fig. 7Male, 41\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC lymphocyte count, elevated CRP. CT shows multiple consolidation, GGO, and AB sign'], '42058_2020_31_Fig8_HTML': ['The shape is related to the distribution pattern. Common shapes include patchy, cone-shape or triangle, subsegmental, and segmental. Sometimes, round or centrilobular nodule with halo sign [17] or reversed halo sign [18] also can be seen. The interface between lesion and the normal pulmonary is often ill-defined. Occasionally, the mosaic perfusion may be present (Figs.\xa0<xref rid="42058_2020_31_Fig8_HTML" ref-type="fig">8</xref>, , <xref rid="42058_2020_31_Fig9_HTML" ref-type="fig">9</xref>, , <xref rid="42058_2020_31_Fig10_HTML" ref-type="fig">10</xref>, , <xref rid="42058_2020_31_Fig11_HTML" ref-type="fig">11</xref>, , <xref rid="42058_2020_31_Fig12_HTML" ref-type="fig">12</xref>, , <xref rid="42058_2020_31_Fig13_HTML" ref-type="fig">13</xref>). Halo sign is defined as a circle of GGO surrounding a soft tissue density lung nodule, may be seen in some patients with a solitary pulmonary nodule. The histologic nature of halo varies with the disease, such as the hemorrhage, and lipid spread of tumor. The halo sign in patients with COVID-19 may be caused by the alveolar edema and hemorrhage. While reversed-halo sign may be related to the organization and resolution of alveolar exudates.). Halo sign is defined as a circle of GGO surrounding a soft tissue density lung nodule, may be seen in some patients with a solitary pulmonary nodule. The histologic nature of halo varies with the disease, such as the hemorrhage, and lipid spread of tumor. The halo sign in patients with COVID-19 may be caused by the alveolar edema and hemorrhage. While reversed-halo sign may be related to the organization and resolution of alveolar exudates.Fig. 8Male, 40\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, no fever, no cough, normal WBC, decreased lymphocyte count, elevated CRP and ESR. CT shows multiple patchy, ill-defined consolidation, GGO, thickening of intralobular septa and fibrosis. AB sign and mosaic perfusion was seenFig. 9Male, 29\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, sore throat, normal WBC and lymphocyte count. CT shows multiple centrilobular nodules, thickening of the adjacent small vessels, and cone-shape in the apical segment of right upper lobeFig. 10Female, 58\xa0years. Close contact with confirmed case, fever, cough, nasal congestion, and runny nose. CT shows multiple subpleural GGO with thickening of small vessel, and cone-shape in the left upper lobeFig. 11Male, 51\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, decreased WBC and lymphocyte count, elevated CRP. CT shows bilateral, round GGO with AB signFig. 12Male, 25\xa0years. A history of travel to Vietnam, fever, cough, normal WBC, decreased lymphocyte count and elevated CRP. CT shows consolidation surrounded by the GGO (halo sign) in the left upper lobeFig. 13Female, 21\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, runny nose and diarrhea, decreased WBC and lymphocyte count, elevated CRP. CT shows multiple small patchy GGO with ill-defined margin'], '42058_2020_31_Fig14_HTML': ['The typical and most common internal features are ‘crazy-paving’ sign (GGO superimposed the thickening of interlobular or intralobular septa), thickening of small vessels with natural course, and air bronchogram (AB) (80%, 41/51). Sometimes, bronchovascular bundle is thickened within the lesion. Cavity can occur in occasion [16] (Figs.\xa0<xref rid="42058_2020_31_Fig14_HTML" ref-type="fig">14</xref>, , <xref rid="42058_2020_31_Fig15_HTML" ref-type="fig">15</xref>, , <xref rid="42058_2020_31_Fig16_HTML" ref-type="fig">16</xref>).).Fig. 14Male, 65\xa0years. No epidemiological history, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated ESR and LDH. CT shows subpleural GGO with AB sign, thickening of intralobular septa (crazy-paving sign) and thickening of small vesselsFig. 15Male, 42\xa0years. A history of travel to Wuhan in the last 2\xa0weeks, fever, cough, nasal congestion, and runny nose, normal WBC, decreased lymphocyte count, elevated CRP. CT shows GGO with AB sign and thickening of small vesselsFig. 16Male, 33\xa0years. A history of close contact with the fever person from Wuhan, fever, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows GGO and thickening of small vessels with natural course in the right lower lobe'], '42058_2020_31_Fig17_HTML': ['The common changes of adjacent structures include the thickening and/or shifting of pleural (Fig.\xa0<xref rid="42058_2020_31_Fig17_HTML" ref-type="fig">17</xref>). The subpleural region may be spared (Fig.\xa0). The subpleural region may be spared (Fig.\xa0<xref rid="42058_2020_31_Fig18_HTML" ref-type="fig">18</xref>) or not [) or not [22], speculating related to the amount of alveolar exudates and the distance to the pleural. Pleural effusion, pericardial effusion and lymphadenopathy are rare.Fig. 17Male, 49\xa0years. Close contact with the confirmed case, fever, cough, hypoxemia, normal WBC, decreased lymphocyte count, elevated CRP, ESR and LDH. CT shows multiple GGO with crazy-paving sign, thickening of small vessels and shifted bilateral oblique fissureFig. 18Female, 38\xa0years. A history of close contact with the fever person from Wuhan, cough, mild chest tightness, normal WBC, decreased lymphocyte count, elevated CRP and LDH. CT shows subpleural consolidation sparing the pleural surface in the right lower lobe'], '42058_2020_31_Fig19_HTML': ['The evolution process of COVID-19 on CT image is not quite clear yet. Feng et al. [23] reviewed 21 patients recovering from COVID-19 (without severe respiratory distress during the disease course). The mean interval between baseline and follow-up CT scans was 4\u2009±\u20091\xa0days, and the mean hospitalization duration was 17\u2009±\u20094\xa0days. The majority of cases with COVID-19 were controlled with stable and improving conditions after effective personalized treatment. The peak severity was at approximately 10\xa0days and the improvement happened at approximately 14\xa0days after initial onset of symptoms. The follow-up CT showed that the lesions in lungs were decreased in both number and size. The density of lesions was reduced as well [12, 24]. The CT findings of clinically cured cases showed full recovery or only small amounts of residual stripes (Fig.\xa0<xref rid="42058_2020_31_Fig19_HTML" ref-type="fig">19</xref>). For some cases, the GGO and consolidation in lungs became some thick fibrotic stripes in short term, which need follow-up studies to explore its final outcome.). For some cases, the GGO and consolidation in lungs became some thick fibrotic stripes in short term, which need follow-up studies to explore its final outcome.Fig. 19Female, 62\xa0years. From Wuhan, fever for 5\xa0days, normal WBC and decreased lymphocyte count, elevated CRP and PCT. The CT obtained at first day after admission showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 3\xa0days later showed the consolidation were smaller in size and the GGO became diffused. The follow-up CT 16\xa0days later showed consolidation and GGO were resolved instead of fibrous strips'], '42058_2020_31_Fig20_HTML': ['Chest X-ray may show no abnormality, therefore it is not recommended as a screening tool in children. CT findings of COVID-19 in children were variable and non-specific. The GGO and consolidation were also the most common findings in bilateral lungs, while the lesions in children were less diffused than adults [25]. One relative specific CT characteristics in children was the presentation mimic bronchopneumonia. Pleural effusion and lymphadenopathy were also not observed (Fig.\xa0<xref rid="42058_2020_31_Fig20_HTML" ref-type="fig">20</xref>).).Fig. 20Female, 8\xa0years. Clustering occurrence, fever, pharyngalgia, normal WBC and decreased lymphocyte count, elevated CRP. CT showed bilateral, multiple and subpleural GGO and consolidation. The follow-up CT 5\xa0days later showed the lesions were smaller in size and lighter in density']} | Progress and prospect on imaging diagnosis of COVID-19 | [
"COVID-19",
"Imaging",
"Viral pneumonia",
"Artificial intelligence"
] | Chin J Acad Radiol | 1584514800 | None | null | other | PMC7149076 | null | null | [
""
] | Chin J Acad Radiol. 2020 Mar 18; 3(1):4-13 | NO-CC CODE |
|
(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs | 313891_1_En_17_Fig110b_HTML | 7 | 5526a48dae3face516d842ba229b164bac3062f56c5e811bb1e725778fd20823 | 313891_1_En_17_Fig110b_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
782,
865
] | [{'image_id': '313891_1_En_17_Fig115b_HTML', 'image_file_name': '313891_1_En_17_Fig115b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig115b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lung cancer. (a–f) CT scanning demonstrates diffuse soft tissue density shadows in left upper lung, round liked mass shadows in the middle lung field, thickened pleura in the lateral chest wall with adhesion, and strip liked liquid density shadows', 'hash': '37ffef88f4c6dffdd2849b9994419efe1bf8f369ad111d82071f2f004a9fa43f'}, {'image_id': '313891_1_En_17_Fig106a_HTML', 'image_file_name': '313891_1_En_17_Fig106a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig106a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related lymphoma. (a–b) DR demonstrates enlarged and thickened left hilum in a huge mass shadow. High KV demonstrates a huge mass shadow in the hilum. (c–h) CT scanning of the pulmonary window demonstrates a huge high density mass shadow in the left hilum, surrounding nodular fusion shadows in the lung tissues. CT scanning of the mediastinal window demonstrates a huge high density mass shadow in the left hilum, with air bronchogram sign in the shadow', 'hash': '1ff6a74f6517ed666fda8da1eb38cd58b7d92c3687c533350df4caf4cb7ba7d7'}, {'image_id': '313891_1_En_17_Fig67a_HTML', 'image_file_name': '313891_1_En_17_Fig67a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig67a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows. (e–h) Reexamination of the pulmonary window after 3 months treatment demonstrates multiple scattered round liked nodular shadows and thick wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows which obviously increase and enlarge compared to previous lesions, with accompanying infiltration shadows around the lesions', 'hash': '75b2dd5456ce09da0ace0b9787ea5a36d49c80e174314762343564032297b51c'}, {'image_id': '313891_1_En_17_Fig14_HTML', 'image_file_name': '313891_1_En_17_Fig14_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig14_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, mass and flakes of parenchymal shadows in the posterior segment of the right upper lobe and in the dorsal segment of both lower lobes which is more obvious in the right lung, and bronchial shadows in them', 'hash': 'bc4343d2071f380a05855c1e658dc05d90d8ae123e988cfe12c3e65526b3336c'}, {'image_id': '313891_1_En_17_Fig104_HTML', 'image_file_name': '313891_1_En_17_Fig104_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig104_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymphoid interstitial pneumonia. (a–f) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs in reticular appearance, with accompanying multiple small nodular shadows, fusion of some nodules into flaky shadows, and ground glass liked changes in the lung fields', 'hash': '4883f041ed6e05ad0ce9ee6734fea4171aae151209ba36cbce94c8434c86f174'}, {'image_id': '313891_1_En_17_Fig98b_HTML', 'image_file_name': '313891_1_En_17_Fig98b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig98b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates thickened lung markings in both lungs, which extend to the outer zone of the lungs. (b) DR demonstrates thickened and deranged lung markings in both lungs with nodular blurry shadows; and cloudy shadows in lung fields. (c, d) CT scanning demonstrates thickened lung markings in both lungs, with diffuse nodular shadows; and cloudy changes in lung fields. (e) HE staining demonstrates cytomegalovirus inclusions', 'hash': '489286db9d367c09fbc842e4d1ba093d9caa6ded75760e9e1a70e05a86f43979'}, {'image_id': '313891_1_En_17_Fig53_HTML', 'image_file_name': '313891_1_En_17_Fig53_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig53_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) Anteroposterior and lateral DR demonstrates enlarged and thickened left hilum, and large flaky blurry shadows with increased density in the left lower lung. (c, d) Reexamination demonstrates normal lungs after antibiotic treatment', 'hash': 'd9cd861c21f1100d02e20014901c7e4a9a9bcad2e4ddcd3c731b50168d8782be'}, {'image_id': '313891_1_En_17_Fig114b_HTML', 'image_file_name': '313891_1_En_17_Fig114b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig114b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related Kaposi’s sarcoma. (a–d) CT scanning demonstrates scattered cloudy mass and flakes liked or nodular shadows with increased density in both lungs with uneven density and unclear boundaries, fusion and parenchymal changes of some lesions, more lesions in the lower lobe of both lungs and mostly with parenchymal changes. (e, f) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large and thick stained nucleoli, which are in line with the manifestations of Kaposi’s sarcoma. (g, h) Immunohistochemical demonstrates positive of C3 and C4', 'hash': '586be9acfd2434fad0db1a2ffaba9ac72eb8eb799b76acdaeac2730c48c45020'}, {'image_id': '313891_1_En_17_Fig107a_HTML', 'image_file_name': '313891_1_En_17_Fig107a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig107a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related lymphoma. (a–e) CT scanning of the pulmonary and mediastinal windows demonstrates multiple round liked nodular shadows with increased density in both lung fields, with clear boundaries; large soft tissue mass shadows in the right lower lung, with slightly lobulated boundaries and spikes. (f–i) CT scanning of the pulmonary and mediastinal windows for reexamination after radiation therapy demonstrates shrinkage of intrapulmonary nodules and masses', 'hash': '4ca6acd1461c3d7b80869d7d33bd1a3d91ecd1a0dc1b5c7baecc0bfbcf817449'}, {'image_id': '313891_1_En_17_Fig75b_HTML', 'image_file_name': '313891_1_En_17_Fig75b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig75b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval or sphere shaped nodular shadows in the cavities with smooth boundaries. (e, f) Reexamination after treatment demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval nodular shadows in the cavity with smooth boundaries. Compared to the previous imaging findings, the lesions are shrunk, with improved surrounding infiltration', 'hash': 'b1a96158009afcb5e673cf31f9243ca598c763c294bbdc7479a918fb36b031e8'}, {'image_id': '313891_1_En_17_Fig25d_HTML', 'image_file_name': '313891_1_En_17_Fig25d_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25d_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '1e7425ad1ac60b1c612434d02bbe7d48ba0fb82e0642b09b8771b4fea9a7a4c2'}, {'image_id': '313891_1_En_17_Fig66a_HTML', 'image_file_name': '313891_1_En_17_Fig66a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig66a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates large flaky shadows with increased density in the right upper lung, with blurry boundaries; round liked or sphere shaped mass shadows in the right lower lung, with uneven density. (b–e) CT scanning of the pulmonary window demonstrates multiple round liked thick-wall cavities in the dorsal segment of the right lower lung, with small nodular shadow adhering on the cavity wall; and surrounding small nodular shadows and infi ltration shadows. (f, g) Coronal CT scanning reconstruction demonstrates a huge thick-wall cavity in the right upper lung, with irregular thickness of the wall; round liked cavity shadows in the right lower lung, with thick and multilocular walls; and flaky shadows with increased density in the outer zone of the left lower lung', 'hash': 'efec688fc6d0fd9fc9188edcc4a4bb040754e9c9e3261fcacec068f3bfd0252f'}, {'image_id': '313891_1_En_17_Fig63_HTML', 'image_file_name': '313891_1_En_17_Fig63_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig63_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Rhodococcus equi pneumonia. (a) Pulmonary CT scanning demonstrates a mass shadow in the lateral segment of the right middle lobe in size of 4.7\u2009×\u20093.7\u2009×\u20093.2 cm with uneven density and lace liked boundary, and small bubbles shadows in it. By both sputum culture and lung tissue culture, Rhodococcus equi can be detected. (b, c) Pathological biopsy and HE staining demonstrate inflammatory pseudotumor. (d, e) Immunohistochemistry demonstrates Rhodococcus equi antibody positive. (f) Reexamination after treatment demonstrates obvious shrinkage of the original lung lesions', 'hash': 'ac97b316499d751a48d8b861962da376a39c7ff11d2554ed957c226224dc65b6'}, {'image_id': '313891_1_En_17_Fig2a_HTML', 'image_file_name': '313891_1_En_17_Fig2a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig2a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered miliary increased density shadows in both lungs, with even size, density and distribution. The shadows of both hila are dense, with sharp both costophrenic angles. (b–f) CT scanning demonstrates scattered miliary nodular shadows in both lungs, which is more obviously in the middle pulmonary strip and with quite even size and density. Trachea and bronchi are unblocked', 'hash': 'ec4f2f75b5bb59b2cb13f016c2ea6714bdc3c908077c2697af2218aa485876b7'}, {'image_id': '313891_1_En_17_Fig13a_HTML', 'image_file_name': '313891_1_En_17_Fig13a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig13a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, transparent areas in them and unblocked trachea and bronchi', 'hash': '7d26c2f94a34f3ff7c4f64d485fe29e114936d0f4db53489ee88148a1a6fc8bf'}, {'image_id': '313891_1_En_17_Fig65a_HTML', 'image_file_name': '313891_1_En_17_Fig65a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig65a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related allergic pulmonary Aspergillus infection. (a–f) CT scanning of the pulmonary window demonstrates thickened central pulmonary markings in both lungs, which is turtuous and deranged with fingertip infiltration shadows. (g) DR demonstrates hyperinflation of the right lung, increased and thickened pulmonary markings and ground glass liked shadows with increased density in the right lower lung and left lung lobe', 'hash': '6fa5ade163d7465c0dc3eb89ebc58d57b98674fc2680824cc5a81c478b81fbc4'}, {'image_id': '313891_1_En_17_Fig76b_HTML', 'image_file_name': '313891_1_En_17_Fig76b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig76b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning demonstrates diffuse scattered thin ground glass liked, patchy, flaky blurry shadows and cords liked shadows in both lungs, with blurry boundaries and uneven density; scattered nodular shadows in different sizes; more lesions in both upper lobes and the right middle lobe; flaky parenchyma shadows in the apical and posterior segments of right upper lobe, with air bronchogram sign in them; unobstructed opening of bronchi as well as lobar and segmental bronchi without stenosis and obstruction; lymphadenectasis in the right hilar region; detected Aspergillus fumigatus by sputum culture. (e, f) Culture for 72 h, lactic acid gossypol blue staining and microscopic observation at ×200 and ×400 demonstrate short column liked conidial head, smooth wall of conidiophores, flask-shaped top capsule and monolayer microconidiophores. (g) Culture in Paul’s medium demonstrates dark green colored colonies', 'hash': 'af925cb00cbd4eed9e67dc49fd012909ecdfe48493ac645d8b2185eb4f351655'}, {'image_id': '313891_1_En_17_Fig105a_HTML', 'image_file_name': '313891_1_En_17_Fig105a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig105a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary toxoplasmosis. (a–d) CT scanning demonstrates thickened pulmonary markings in both lungs, which can be enhanced to extend into the middle and outer zones of lungs, in grid liked appearance that is more obvious in the dorsal segment of the lungs. (e) It is demonstrated to have clustering toxoplasma tachyzoites', 'hash': '30f16a35256e45c89dfcd68adf661507960a5b978db88cc531a7605d9fff53df'}, {'image_id': '313891_1_En_17_Fig95_HTML', 'image_file_name': '313891_1_En_17_Fig95_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig95_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a) CT scanning of the pulmonary window demonstrates irregular large flaky shadows with increased density in the dorsal segment of both lower lobes; enlarged hilum in both lungs, cords liked thickening of the vascular vessels. (b) CT scanning of the mediastinal window demonstrates flaky parenchyma shadows in the left lower lung, thickening of both pleura, enlarged hilum shadows in both lungs, thickened right lower bronchial wall. (c) Microscopy after culture at 25 °C demonstrates branches and separated hyphae and its string of small spores, with typical penicillus but no sporangium (Medan staining, ×400). (d) Bone marrow smear demonstrates round or oval cells like the yeast phase within the macrophages; longer cells like the yeast phase outside the macrophages. The two kinds of cells have slightly curved ends in sausages liked appearance (HE staining, ×400)', 'hash': '636de07e02ba7cf1f73f2a03bccf4fdaac68bc4a122b7fbfe2febe72dd42f139'}, {'image_id': '313891_1_En_17_Fig3a_HTML', 'image_file_name': '313891_1_En_17_Fig3a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig3a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy and scattered miliary increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of the lower lung field, with some fused in thin cloudy shadows', 'hash': 'e655c40874d38beaa8a8e9f0e82c1eb12a6756b09bee559229354b3756010a18'}, {'image_id': '313891_1_En_17_Fig73_HTML', 'image_file_name': '313891_1_En_17_Fig73_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig73_HTML.jpg', 'caption': '(a–c) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates diffuse dense shadows in both lower lung fields which is in a arcuate surface with exterior high and interior low (pleural effusion). (b, c) CT scanning of the mediastinal window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavities; thickened pleura of the lateral chest wall, with accompanying encapsulated effusion', 'hash': '9ad36ea5213bea731770658b27be87e1af9e34bced02cda664a7f485e40f2315'}, {'image_id': '313891_1_En_17_Fig54_HTML', 'image_file_name': '313891_1_En_17_Fig54_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig54_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates round liked large flaky shadows with increased density in the left lower lung, enlarged and thickened hilus. (c, d) DR reexamination after treatment demonstrates flocculent shadows in the left lower lung, with improved conditions than previous findings before treatment (a, b)', 'hash': 'f9b4f22920ef55d9110380df6f64a6a508ecea9ca3192877a2d47400e781c58d'}, {'image_id': '313891_1_En_17_Fig58b_HTML', 'image_file_name': '313891_1_En_17_Fig58b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig58b_HTML.jpg', 'caption': '(a–i) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) CT scanning of the pulmonary window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (c, d) CT scanning of the mediastinal window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, pulmonary atelectasis and pleural effusion, with ventilation shadows in them. (e) CT scanning of the pulmonary window after the treatment demonstrates absence of the mass shadows in the left lower lung with transverse stripes shadows, obviously improved than previous findings (a, b). (f) HE staining demonstrates thickened alveolar septa and exudates from the alveolar cavity. (g) HE staining demonstrates massive bleeding in the alveolar cavity, large quantity erythrocytes and intact cell walls. (h) HE staining demonstrates phagocytized basophilic granules in the leukocytes. (i) HP staining demonstrates purplish red Rhodococcus equi in a shape of crescent in orange red sputum', 'hash': 'ca8456a79f660fc4faa5eb9342f84a14bbe25eedd8fb237ac65bd96b8de6e5b9'}, {'image_id': '313891_1_En_17_Fig25c_HTML', 'image_file_name': '313891_1_En_17_Fig25c_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25c_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '64e0ceda545f1684d11c717eef852c6576036d711540954850cc018aadfefa87'}, {'image_id': '313891_1_En_17_Fig44_HTML', 'image_file_name': '313891_1_En_17_Fig44_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig44_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary nontuberculous mycobacterial infection. (a–d) CT scanning demonstrates multiple cavities in the left lung field, bilateral multiple lobular central nodules and extensive branches liked linear shadows in tree buds sign. There are also large flaky parenchymal changes of the lung tissues in the left lower lung field in high density shadows, with accompanying air bronchogram sign. (e) HE staining demonstrates avium intracellular complex mycobacteria infection of lung tissues in atypical tuberculous nodular changes. (HE\u2009×\u2009200)', 'hash': '8f8697761c60c3cb27c0b413c2e19433df26ba07a74ea0a0cc0b6f2b4acc7b65'}, {'image_id': '313891_1_En_17_Fig103_HTML', 'image_file_name': '313891_1_En_17_Fig103_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig103_HTML.jpg', 'caption': '(a–d) HIV/AIDS related lymphoid interstitial pneumonia. (a–d) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs, in reticular appearance; with accompanying multiple small nodular shadows', 'hash': '8d52c3bac6fb07e3eaf12386767e159f762db3072e09365be542c937697babe7'}, {'image_id': '313891_1_En_17_Fig110b_HTML', 'image_file_name': '313891_1_En_17_Fig110b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110b_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '5526a48dae3face516d842ba229b164bac3062f56c5e811bb1e725778fd20823'}, {'image_id': '313891_1_En_17_Fig5a_HTML', 'image_file_name': '313891_1_En_17_Fig5a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig5a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates patchy shadows with increased density in both lungs, with thickened hilar shadows in both lungs. (b–g) CT scanning demonstrates flaky ground glass liked density shadows in upper lungs and dorsal segment of both lungs, which is more obvious in the middle inner strips. There are extrapulmonary stripes transparent shadows, with some bronchial walls thickened and enlarged hilar shadows in both lungs', 'hash': '5d6ab0400e0331b0fcb3a3679023a44fa81b7b9c9eedc00c0ddb6d85208c3512'}, {'image_id': '313891_1_En_17_Fig74_HTML', 'image_file_name': '313891_1_En_17_Fig74_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig74_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates round liked uneven density shadows in the medial segments of both middle and lower lungs, multilocular hollow holes in the cavities, surrounding multiple round liked thick-wall small cavity shadows and ground grass liked infiltration shadows. (b–d) CT scanning of the pulmonary window demonstrates scattered round liked uneven density shadows in the right hilum and lower lung, multilocular hollow holes in the cavities; and surrounding multiple round liked thick-wall small cavity shadows and ground grass liked infiltration shadows', 'hash': 'e4c42cc0cb1f1bdfa8b2cc1f3c8eab7223c4be368a808e8b6c4b01af78dfb04a'}, {'image_id': '313891_1_En_17_Fig23_HTML', 'image_file_name': '313891_1_En_17_Fig23_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig23_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymph node tuberculosis. (a–c) CT scanning of the pulmonary window demonstrates dense mass shadow beside the right aortic arch, and thinner right bronchus due to compression. (d–f) CT scanning of the mediastinal window demonstrates low density mass shadow besied the right aortic arch with clear boundary', 'hash': '8d135ce7e96005006343dc3305be0f8c77d0828bccccf1726226c09fd47c365f'}, {'image_id': '313891_1_En_17_Fig6a_HTML', 'image_file_name': '313891_1_En_17_Fig6a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig6a_HTML.jpg', 'caption': '(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe', 'hash': '235548456c9bf72727a05a91fa6893d8a478f8f715c022d6b579d4a9188da366'}, {'image_id': '313891_1_En_17_Fig17a_HTML', 'image_file_name': '313891_1_En_17_Fig17a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig17a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchymal shadows and fibrous cords liked shadows in both lungs which are more obvious in both lower lungs. The trachea and bronchi are unblocked, with enlarged hilar shadows in both lungs', 'hash': '9c1c59095291dcf6a7b6dec786ec58ba44e9b83badfe4bbf121b7c677476f4d5'}, {'image_id': '313891_1_En_17_Fig113b_HTML', 'image_file_name': '313891_1_En_17_Fig113b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig113b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Kaposi’s sarcoma. (a–d) Chest CT scanning demonstrates scattered cloudy, mass and flake liked or nodular shadows with increased density. (e) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large thick stained nucleoli, which are in line with the diagnosis of Kaposi’s sarcoma. (f–i) Cured HIV/AIDS related Kaposi’s sarcoma. (f–i) Reexamination after treatment demonstrates absent lesions in both lungs, with clear lung fields', 'hash': '88e574b2d5ff4ee4ce28f38025d5345c8cf6b50386f752ae12083b05fe7af9de'}, {'image_id': '313891_1_En_17_Fig82_HTML', 'image_file_name': '313891_1_En_17_Fig82_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig82_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a, b) DR demonstrates enlarged blurry hilum in both lungs and thickened pulmonary markings. (c, d) CT scanning demonstrates mediastinal lymphadenectasis, narrowed trachea due to compression with liquefactive necrosis. Enhanced scanning demonstrates marginal enhancement and no central enhancement', 'hash': '18312183daaefbc6c48e05e67fab210a1109c24a6f94311ffb11ffdace007a49'}, {'image_id': '313891_1_En_17_Fig64_HTML', 'image_file_name': '313891_1_En_17_Fig64_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig64_HTML.jpg', 'caption': '(a) Gross observation demonstrates dark brown lungs in appearance. (b, c) Thology demonstrates hemorrhage and edema of the lung tissue and focal necrosis, with large quantity Aspergillus hyphae and spores in the surrounding area of the necrosis (Combined with pulmonary CMV infection)', 'hash': '104850f2999da711317f4e4f07e590bd8f73a93731daf090ece6023192606e90'}, {'image_id': '313891_1_En_17_Fig7a_HTML', 'image_file_name': '313891_1_En_17_Fig7a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig7a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates diffusely distributed shadows with increased density in both lungs that is more obvious in the middle and lower lungs. The hilar shadows in both lungs are enlarged. Both diaphragmatic surfaces and phrenic angles are blurry. (b–d) CT scanning demonstrates flaky shadows with increased density in both lungs, with parenchymal shadows in the lingular segment of left upper lobe and in the dorsal segments of both lower lobes and bronchial shadows in them. There are also thickened bronchial walls and enlarged hilar shadows in both lungs', 'hash': '431aab0770a1915c719095cc2bab91736f1ffda7b5649cdca5d8b7516003049c'}, {'image_id': '313891_1_En_17_Fig33_HTML', 'image_file_name': '313891_1_En_17_Fig33_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig33_HTML.jpg', 'caption': '(a, b) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates scattering patchy and cords liked blurry density shadows in the right middle and upper lung fields as well as enlarged and thickened hilum. (b) DR demonstrates that the lungs lesions are almost absent compared to (a), after anti-TB treatment for 5 months', 'hash': 'e710598bbbc8286721136f2a803716198a712c55253c4232d3ee33b2e33e188b'}, {'image_id': '313891_1_En_17_Fig62_HTML', 'image_file_name': '313891_1_En_17_Fig62_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig62_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) Anteroposterior and lateral DR demonstrates huge sphere liked mass shadow in the right hilum, with cavities shadows and liquid gas level in it. (c) HE staining demonstrates bleeding in the lung tissues and aggregation of large quantity lymphocytes. (d) Masson staining demonstrates branches liked purplish red Rhodococcus equi', 'hash': '261a4aca9e146cc16957c6280cd4795d7c2c5732d9a19006b6e398a1ae410af0'}, {'image_id': '313891_1_En_17_Fig84_HTML', 'image_file_name': '313891_1_En_17_Fig84_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig84_HTML.jpg', 'caption': '(a, b) HIV/AIDS related pulmonary cryptococcus infection. (a) CT scanning demonstrates round liked cavity shadows in the left upper and lower lung, with uneven thickness of the cavity wall and surrounding infiltrative shadows. (b) CT scanning demonstrates round liked dense mass shadows in the right upper lung, with clear boundaries and bulky drainage vessel shadows', 'hash': 'ecc614167ec536dcb80c2739886c957ff2f182dd49ac7f4d6379260497262e60'}, {'image_id': '313891_1_En_17_Fig4_HTML', 'image_file_name': '313891_1_En_17_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig4_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy or ground glass liked increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of lower lungs, with some fused into thin cloudy ground glass liked shadows with increased density, with decreased transparency of both lungs and enlarged hilar shadows in both lungs', 'hash': '636f9fd3d3c20c17e15e1ac70adcdcb6fbe268a70ac64d29317f73045747e226'}, {'image_id': '313891_1_En_17_Fig46a_HTML', 'image_file_name': '313891_1_En_17_Fig46a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig46a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates large flaky dense shadows in the middle-outer zone of the left middle lung field, and narrowed left bronchus. (d–f) CT scanning demonstrates large flaky shadows with uneven density in the left lateral chest wall and even lower density shadow in them', 'hash': 'afdfc2c33070f1d3b8616a542d989e0f908d9638327227057dfdf5ed59169359'}, {'image_id': '313891_1_En_17_Fig72_HTML', 'image_file_name': '313891_1_En_17_Fig72_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig72_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and cavity shadows in both lungs, with even wall thickness and small nodular shadows in some cavities', 'hash': 'd318b47b9b56854b6bc47081b08712ee9d828a2ae4592aa69451ec7105fd0240'}, {'image_id': '313891_1_En_17_Fig91b_HTML', 'image_file_name': '313891_1_En_17_Fig91b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig91b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–e) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of some lesions into honeycomb likes cavity shadows or plaque liked dense shadows. (f–h) CT scanning demonstrates large thick-wall cavity shadows in the right lung, surrounding plaque and round liked small cavity shadows and inflammatory infiltrative shadows', 'hash': '6b3a934b89abf6f7e8c9593337c0c57fe44161bcbfc546c7e2a3cfa50539f91e'}, {'image_id': '313891_1_En_17_Fig8a_HTML', 'image_file_name': '313891_1_En_17_Fig8a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig8a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates large flaky parenchyma shadows in both lungs which is more obvious in the middle and lower lobes of both lungs. There are also enlarged hilar shadows in both lungs and sharp both costophrenic angles. (b–g) CT scanning demonstrates large flaky parenchyma shadows in concentric and symmetrical distribution, bronchial shadows in them and thickened bronchial walls', 'hash': '7c4f2f4f9120af70727cab6fc69637733e17e807575648a0257b5b03367da625'}, {'image_id': '313891_1_En_17_Fig42_HTML', 'image_file_name': '313891_1_En_17_Fig42_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig42_HTML.jpg', 'caption': 'HIV/AIDS related tuberculous pleuritis. DR demonstrates arch shaped dense shadows with higher exterior density and lower interior density in the left lower lung field and covered right edge of the heart', 'hash': 'f0dfdb1b349a42c7092daeeaef76a8b8762e134b40ae21a6144d9785b9ddcd02'}, {'image_id': '313891_1_En_17_Fig15_HTML', 'image_file_name': '313891_1_En_17_Fig15_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig15_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy blurry shadows and fibrous cords liked shadows in both lungs which are more obvious in the middle inner parts of both lungs, with transparent areas in them. The bronchial walls are thickened', 'hash': '4d262b5c06f74783c1b6df1f8c9d8c7ecbf235faacd2f2e846544a3e11d88e8b'}, {'image_id': '313891_1_En_17_Fig92b_HTML', 'image_file_name': '313891_1_En_17_Fig92b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig92b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs', 'hash': '4613e0bd8bbb013024b2335ae2f7fb1997dab5d93ee1c395c97035d6e7d37750'}, {'image_id': '313891_1_En_17_Fig52_HTML', 'image_file_name': '313891_1_En_17_Fig52_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig52_HTML.jpg', 'caption': '(a, b) HIV/AIDS related staphylococcus aureus pneumonia. (a, b) DR demonstrates diffuse scattered multiple thin-walled transparent areas in both lungs, increased and blurry pulmonary markings, and enlarged heart shadow in flask shape (pericardial effusion)', 'hash': 'b54d395f8405b646839c68cb58c1a811c70fb8c7337443d24b61bfcfa097f5b0'}, {'image_id': '313891_1_En_17_Fig56b_HTML', 'image_file_name': '313891_1_En_17_Fig56b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig56b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates huge round large flaky shadows with increased density in the left lower lung, enlarged and thickened hilum and covered right heart edge. (c, d) DR reexamination after treatment for 1 week demonstrates flocculent shadow in the left lower lung, improved than those before the treatment (a, b). (e) DR reexamination after treatment demonstrates flocculent liked shadows in the left lower lung, obviously improved than before the treatment (c, d)', 'hash': 'e5f534ed9282980e95aaa6bac04091762128cf3e5c46985b190278c5d6396558'}, {'image_id': '313891_1_En_17_Fig93b_HTML', 'image_file_name': '313891_1_En_17_Fig93b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig93b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates diffuse small cavity in honeycomb liked and infiltrative parenchyma shadows, with the hilum as the center to distribute bilaterally symmetric like butterfly wings; multiple honeycomb liked cavity shadows in both lungs. (e–h) CT scanning reexamination demonstrates large irregular thick-wall cavities in the right lung, surrounding scattering nodular, honeycomba liked and infiltrative shadows after anti-PM infection treatment for 3 months', 'hash': '904e5a590c601ab02150f8c2487bbfa6f0282c1eddd547624ce8c549472221d9'}, {'image_id': '313891_1_En_17_Fig51b_HTML', 'image_file_name': '313891_1_En_17_Fig51b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig51b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related staphylococcus aureus pneumonia. (a) Chest X-ray demonstrates large flaky high density shadow in the left middle-lower lung field, with central transparent areas in different sizes and blurry boundaries; parenchyma changes of the left lower lung, predominantly in the posterior and exterior basal segments; unobstructed brounchus and thickened adjacent pleura. (b–d) CT scanning demonstrates large flaky shadows in fan shaped distribution along the bronchus in the left middle-lower lung, with gas containing cavities and high density shadows; and thickened adjacent pleura of the lateral chest wall. (e, f) CT scanning of the mediastinal window demonstrates large flaky fan shaped parenchymal shadows in the left middle-lower lung field, with ventilation shadows in them; and thickened pleura of the lateral chest wall. (g, h) Pathological examination showed staphylococcus aureus', 'hash': '18a6e1202b7b8c4a2d57fe024b7e8039a6dcee0f6f5f078b109a93850977c0f6'}, {'image_id': '313891_1_En_17_Fig94b_HTML', 'image_file_name': '313891_1_En_17_Fig94b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig94b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a–f) CT scanning demonstrates multiple nodules and small cavities in honeycomb liked shadows and infiltrative parenchyma shadows in the right lung; flaky transparent areas (bullae of lung) in the right anterior margin of the heart and in the outer zone of the left lung near lateral chest wall', 'hash': '3ed719abaaaec4ee19332842bd8dcac302eb6fefc73152dfd03a39702260d369'}, {'image_id': '313891_1_En_17_Fig34a_HTML', 'image_file_name': '313891_1_En_17_Fig34a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig34a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung and multiple satellite lesions scattering around. (c) CT scanning of the mediastinal window demonstrates lymphadenectasis of aortic window, subcutaneous soft tissue mass shadow in the left anterior chest wall with central low density shadow as well as right axilliary lymphadenectasis', 'hash': 'dabd5722ad3f66eee67ca59ba24417ffb086d4591f3bff2446f2a3490c676e78'}, {'image_id': '313891_1_En_17_Fig22_HTML', 'image_file_name': '313891_1_En_17_Fig22_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig22_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates semicircular mass liked dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura of lateral chest wall, and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates narrowed right thorax, thickend pleura of lateral chest wall with encapsulated effusion, uneven density mass in the right hilum, thinner right bronchus due to compression and no obvious abnormalities in the left hilum. (f) DR in Aug. 2008 demonstrates no obvious changes of the lesions after anti-tuberculosis treatment for 1 month', 'hash': '8f3d47e32ff0f306eed49c4101730b02a154f676752c7bb56423c767388d5b82'}, {'image_id': '313891_1_En_17_Fig27b_HTML', 'image_file_name': '313891_1_En_17_Fig27b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig27b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related miliary tuberculosis. (a–b) Anteroposterior and lateral DR demonstrates diffuse miliary shadows in both lungs, which are bilaterally symmetric and in even size and distribution. (c–f) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': 'e272956e522e945d068939f056c637c5a636df520c687deeac9d40f8cb06834e'}, {'image_id': '313891_1_En_17_Fig83_HTML', 'image_file_name': '313891_1_En_17_Fig83_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig83_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates enlarged blurry hilum in both lungs and thickened lung markings. (b–d) CT scanning demonstrates multiple scattered nodular or mass dense shadows in both lungs, with lobulation, rough spikes around and fusion of some shadows into mass; surrounding small flaky infiltrative shadows; and mediastinal lymphadenectasis', 'hash': '6b17ec5d2db4d953c2436bbec29d0a3b1dacf0910df899eaf97e442c4aaad785'}, {'image_id': '313891_1_En_17_Fig43a_HTML', 'image_file_name': '313891_1_En_17_Fig43a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig43a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related tuberculous pleuritis. (a) DR demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (b) CT scanning of the pulmonary window demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (c) CT scanning of the mediastinal window demonstrates encapsulated fluid density shadow in the pleura of the right lateral chest wall', 'hash': 'ac09c8d3e5e4d73b07cd258411b07337ad06b99883f4a0e4573ce220fc1f4574'}, {'image_id': '313891_1_En_17_Fig35a_HTML', 'image_file_name': '313891_1_En_17_Fig35a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig35a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates diffuse large flaky dense shadows in the right upper lung with transparent areas in them. (b–c) CT scanning of the pulmonary window demonstrates large flaky shadows with increased density in the right upper lung, with multiple satellite lesions scattering around. (d, e) CT scanning of the mediastinal window demonstrates large flaky parenchymal shadows in the right upper lung with air bronchogram sign as well as mediastinal lymphadenectasis', 'hash': 'f556b77354da8136691c411ed446865babea0e399d96d2fca89f49639a04c579'}, {'image_id': '313891_1_En_17_Fig26b_HTML', 'image_file_name': '313891_1_En_17_Fig26b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig26b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '1d1f0589c50a11306fce77c217b0a9ac31be645df14f41d021ccf6522873dc6c'}, {'image_id': '313891_1_En_17_Fig32_HTML', 'image_file_name': '313891_1_En_17_Fig32_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig32_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstratesdiffuse scattering miliary shadows with increased density in both lungs, fusion of some military shadows into patchy or mass liked shadows and diffusely distributed lung lesions', 'hash': '7274d90d4f9483c5fb0e44576eeb46beba54850ed218057b6ca5935c31fa396a'}, {'image_id': '313891_1_En_17_Fig96b_HTML', 'image_file_name': '313891_1_En_17_Fig96b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig96b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a) DR demonstrates flaky blurry dense shadows in the right anterior margin of the heart, with surrounding infiltrative shadows. (b, c) CT scanning of the pulmonary window demonstrates nodular dense shadows in the dorsal segment of the right lower lung, with smooth sharp boundaries; large flaky ground glass liked dense shadows in the dorsal segment of both lungs. (d, e) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in red, in different sizes. (f) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in purplish red, in different sizes', 'hash': 'ad87dabd309e8a0c47d5cd58aa485a538556b1218d18c3cb262dc5b8cd5049e9'}, {'image_id': '313891_1_En_17_Fig55_HTML', 'image_file_name': '313891_1_En_17_Fig55_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig55_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates round liked large flaky shadows with increased density in the right lower lung, cords liked and flocculent liked blurry shadows in both middle-upper lung fields and in the right lower lung field, and enlarged and thickened hilus', 'hash': '29c690f04a28629d1c3b0f7b5665833edd78ec61be199fd2f16199400a7c9eeb'}, {'image_id': '313891_1_En_17_Fig85a_HTML', 'image_file_name': '313891_1_En_17_Fig85a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig85a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates round liked thick-wall cavity in the left hilum, with blurred boundary; ground-glass liked shadows with increased density in the left middle and lower lung. (b–d) CT scanning of the pulmonary window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of cavity wall. (e, f) CT scanning of the mediastinal window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of the cavity wall and surrounding thick spikes', 'hash': 'd6bc5b1be05729f5f4ec60a0cda3bec7f7cf437fd39e0d32743e45cfb9e48de2'}, {'image_id': '313891_1_En_17_Fig112_HTML', 'image_file_name': '313891_1_En_17_Fig112_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig112_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Kaposi’s sarcoma. (a, b) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance', 'hash': 'eeb255e4963802d02da7fd85381532153336be33b21e4ceb488be5dc2a483f29'}, {'image_id': '313891_1_En_17_Fig25b_HTML', 'image_file_name': '313891_1_En_17_Fig25b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25b_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '9ceac8f407a9896d7bda0165bceae81a32d5c5c53de3c5d2a295c165b15071e8'}, {'image_id': '313891_1_En_17_Fig36a_HTML', 'image_file_name': '313891_1_En_17_Fig36a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig36a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) Pulmonary CT scanning of the pulmonary window demonstrates parenchymal shadows in the left lingual lobe with surrounding pulmonary acinar nodular shadows. (b) CT guided pucture biopsy of left lingula. (c) The pathology demonstrates granulation tissue and caseous necrosis, being in consistency with tuberculosis changes. HE\u2009×\u2009100', 'hash': '3a48cc084a1fb1943e1411fa65cfdcee0c3c33377b3ae6ab6e24f04ee1caebae'}, {'image_id': '313891_1_En_17_Fig68a_HTML', 'image_file_name': '313891_1_En_17_Fig68a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig68a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in prone posture demonstrates mass shadow and thick wall cavity in the dorsal segment of the right lower lung, small nodular shadows in the cavities, surrounding fused miliary infiltration shadows. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the dorsal segment of the right lower lung, small nodular shadows in the cavities, and involved pleura of partial lateral chest wall', 'hash': '0acc77833f25b70e7e4527a30be9fc6744e19cee48879415a15e648d76923d48'}, {'image_id': '313891_1_En_17_Fig45_HTML', 'image_file_name': '313891_1_En_17_Fig45_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig45_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Staphylococcus aureus pneumonia. (a) Gross specimen observation demonstrates bilateral purplish brown lesions, patchy white infiltration at the base of the lungs. (b) HE staining demonstrates alveolar diffuse lesions, exudation of the serous fluid and inflammatory cells in the alveolar cavity, and alveolar wall congestion', 'hash': 'e530a1df1ead29989d8b3b50161f1926946446bc5cbbcb99691479816876e341'}, {'image_id': '313891_1_En_17_Fig110c_HTML', 'image_file_name': '313891_1_En_17_Fig110c_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110c_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '22d9f8a4fa731c46a738334c9738c267aaa2c43711aa94bd98c4b78483adda8d'}, {'image_id': '313891_1_En_17_Fig24b_HTML', 'image_file_name': '313891_1_En_17_Fig24b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig24b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates circular mass dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura in the lateral chest cavity and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates multiple uneven mass density shadows in right hilum in a size of about 3\u2009×\u20093.5\u2009×\u20093.8 cm. (f–g) Enhanced CT scanning demonstrates slight uneven enhancement of the lesion and no obvious abnormalties in the left hilum', 'hash': '4c7c3a8f7b0bde1c89efcf634beedfd08159b9be03a95299448e388c435edcdc'}, {'image_id': '313891_1_En_17_Fig12_HTML', 'image_file_name': '313891_1_En_17_Fig12_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig12_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchyma shadows and fibrous cords liked shadows in both lungs which are more obvious in the dorsal segment of both lower lungs, bronchial shadows in them, and thickened bronchial walls in the middle lobe. The hilar shadows in both lungs are enlarged', 'hash': '72a066b603a93a4b8e9a7a8ec1942b2ed87b211dee6ed121b7c56d1cb575c55c'}, {'image_id': '313891_1_En_17_Fig102_HTML', 'image_file_name': '313891_1_En_17_Fig102_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig102_HTML.jpg', 'caption': '(a–d) HIV/AIDS related lymphoid interstitial pneumonia. (a–d) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs, in reticular appearance; with accompanying multiple small nodular shadows', 'hash': '6b569d4d7a5a4f008ea8f7bc4152cd1a576656b8eeee8b7548f00de038815256'}, {'image_id': '313891_1_En_17_Fig111_HTML', 'image_file_name': '313891_1_En_17_Fig111_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig111_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Kaposi’s sarcoma. (a, b) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance, light density flaky shadows in lower lung fields of both lungs. (c) CT scanning demonstrates multiple round liked nodular shadows in both middle lower lung fields with clear boundaries, multiple mediastinal and hilar lymphadenectasis, and small quantity pleural effusion in bilateral thoracic cavities', 'hash': '5dfb9d581ecc41659920bde84bc55d01903bf9f66ec50710fe0465373096ff5f'}, {'image_id': '313891_1_En_17_Fig25a_HTML', 'image_file_name': '313891_1_En_17_Fig25a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25a_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '67db71f0f56d65c929e36f486b4a1a2246ae852aec999328f126ddc09428f814'}, {'image_id': '313891_1_En_17_Fig36b_HTML', 'image_file_name': '313891_1_En_17_Fig36b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig36b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) Pulmonary CT scanning of the pulmonary window demonstrates parenchymal shadows in the left lingual lobe with surrounding pulmonary acinar nodular shadows. (b) CT guided pucture biopsy of left lingula. (c) The pathology demonstrates granulation tissue and caseous necrosis, being in consistency with tuberculosis changes. HE\u2009×\u2009100', 'hash': 'd7d5abe0c9d9bea2e2097dfc72f86922656058f98f8a2360573b04a02e27e5de'}, {'image_id': '313891_1_En_17_Fig68b_HTML', 'image_file_name': '313891_1_En_17_Fig68b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig68b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in prone posture demonstrates mass shadow and thick wall cavity in the dorsal segment of the right lower lung, small nodular shadows in the cavities, surrounding fused miliary infiltration shadows. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the dorsal segment of the right lower lung, small nodular shadows in the cavities, and involved pleura of partial lateral chest wall', 'hash': 'cada0e4684021c74f9b0d4d1bcdb6810379bc035cead748d6de141ebd004f038'}, {'image_id': '313891_1_En_17_Fig96a_HTML', 'image_file_name': '313891_1_En_17_Fig96a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig96a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a) DR demonstrates flaky blurry dense shadows in the right anterior margin of the heart, with surrounding infiltrative shadows. (b, c) CT scanning of the pulmonary window demonstrates nodular dense shadows in the dorsal segment of the right lower lung, with smooth sharp boundaries; large flaky ground glass liked dense shadows in the dorsal segment of both lungs. (d, e) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in red, in different sizes. (f) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in purplish red, in different sizes', 'hash': '020553d48c8545e50d314020ad8dc5004914dca5449aa2b58bc99515f310c3a4'}, {'image_id': '313891_1_En_17_Fig85b_HTML', 'image_file_name': '313891_1_En_17_Fig85b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig85b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates round liked thick-wall cavity in the left hilum, with blurred boundary; ground-glass liked shadows with increased density in the left middle and lower lung. (b–d) CT scanning of the pulmonary window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of cavity wall. (e, f) CT scanning of the mediastinal window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of the cavity wall and surrounding thick spikes', 'hash': '9778eb0d00755e3cd06bd3bcee90d66970730aac4b7fabde0b3e1df25cc067b8'}, {'image_id': '313891_1_En_17_Fig59_HTML', 'image_file_name': '313891_1_En_17_Fig59_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig59_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a–c) CT scanning of the pulmonary window demonstrates thick walled cavities shadows in the dorsal segment of the right lower lung, with irregular wall thickness and liquid gas level in them. (d) CT scanning of the mediastinal window demonstrates thick walled cavities shadows in the dorsal segment of the left lower lung, with irregular wall thickness and liquid gas level in them', 'hash': 'c9ff1150b9c2d245c823a3726a56dc22223fcdc58b24666ee55ee0b01ea0c2d3'}, {'image_id': '313891_1_En_17_Fig24a_HTML', 'image_file_name': '313891_1_En_17_Fig24a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig24a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates circular mass dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura in the lateral chest cavity and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates multiple uneven mass density shadows in right hilum in a size of about 3\u2009×\u20093.5\u2009×\u20093.8 cm. (f–g) Enhanced CT scanning demonstrates slight uneven enhancement of the lesion and no obvious abnormalties in the left hilum', 'hash': 'a3536c779e7c502b855dd3d89ae13854f569bd483ba8038870ac76c68c616c6c'}, {'image_id': '313891_1_En_17_Fig11_HTML', 'image_file_name': '313891_1_En_17_Fig11_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig11_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered patchy shadows with increased density in both lungs and a few cords liked shadows which are more obvious in the right lung. There are thickened both hilar shadows and sharp both costophrenic angles. (b–e) CT scanning demonstrates flaky and mass liked ground glass density shadows in both lungs and a few cords liked shadows which are more obvious in the right lung. The trachea and bronchi are unblocked', 'hash': 'd4448bd9682d4ae721b1250cec042eecf77787519b1af61ac3b2d7b88b28bd90'}, {'image_id': '313891_1_En_17_Fig101_HTML', 'image_file_name': '313891_1_En_17_Fig101_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig101_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Herpes Simplex Viral Pneumonia. (a) DR demonstrates thickened and deranged lung markings in both lungs with accompanying blurry nodular shadows, and cloudy shadows in the lung fields. (b) PAS staining (400×) demonstrates eosinophilic inclusion. (c) Silver methenamine staining demonstrates herpes viral inclusion', 'hash': '9cfda956483a95dc3a4e487426e884d83e6aa0bde654b2c285ba044cf31b2a1d'}, {'image_id': '313891_1_En_17_Fig49_HTML', 'image_file_name': '313891_1_En_17_Fig49_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig49_HTML.jpg', 'caption': '(a–d) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates fan shaped shadow in the right middle lung field with its apex pointing to the hilar dense shadow, with clear boundaries. (d) CT scanning reexamination demonstrates absence of the lesions in the right lung after anti-bacteria treatment for 2 weeks', 'hash': 'f566a271be67724833f92b19b4f73190cae4216ad698f1d1a51c1d9c7579afa1'}, {'image_id': '313891_1_En_17_Fig34b_HTML', 'image_file_name': '313891_1_En_17_Fig34b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig34b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung and multiple satellite lesions scattering around. (c) CT scanning of the mediastinal window demonstrates lymphadenectasis of aortic window, subcutaneous soft tissue mass shadow in the left anterior chest wall with central low density shadow as well as right axilliary lymphadenectasis', 'hash': 'cd2bbefb6363363a2c860069ded9e79b5fabed794f0777f342cd459e7f745581'}, {'image_id': '313891_1_En_17_Fig21_HTML', 'image_file_name': '313891_1_En_17_Fig21_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig21_HTML.jpg', 'caption': '(a–c) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates enlarged right hilum in mass liked dense shadow, with peripheral thickened and blurry pulmonary markings, and no obvious abnormalities of the left hilum. (b) DR demonstrates smaller right hilum after anti-tuberculosis therapy for 1 month. (c) DR demonstrates absent tumor in the right hilum and normal left hilum', 'hash': '46a1a9267e1d610faa6450929c11c8d942047467baf49ba4482ce61bb660cb30'}, {'image_id': '313891_1_En_17_Fig27a_HTML', 'image_file_name': '313891_1_En_17_Fig27a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig27a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related miliary tuberculosis. (a–b) Anteroposterior and lateral DR demonstrates diffuse miliary shadows in both lungs, which are bilaterally symmetric and in even size and distribution. (c–f) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '61497bd4be4942d8a1fc4e6710043c9d4099da58ea99f2008d49f04ec973f2b4'}, {'image_id': '313891_1_En_17_Fig79_HTML', 'image_file_name': '313891_1_En_17_Fig79_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig79_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates multiple scattered nodular shadows in both lower lungs. (b–d) Chest CT scanning demonstrates multiple dense nodular shadows with different sizes and mass shadows in both middle and lower lung fields, with clear boundaries. They are more common in the dorsal segments', 'hash': '7f1588a4af3d4fadaf1f33e3bac3f100d4b2003206bd1bc2ae262b602fd3fe79'}, {'image_id': '313891_1_En_17_Fig51a_HTML', 'image_file_name': '313891_1_En_17_Fig51a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig51a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related staphylococcus aureus pneumonia. (a) Chest X-ray demonstrates large flaky high density shadow in the left middle-lower lung field, with central transparent areas in different sizes and blurry boundaries; parenchyma changes of the left lower lung, predominantly in the posterior and exterior basal segments; unobstructed brounchus and thickened adjacent pleura. (b–d) CT scanning demonstrates large flaky shadows in fan shaped distribution along the bronchus in the left middle-lower lung, with gas containing cavities and high density shadows; and thickened adjacent pleura of the lateral chest wall. (e, f) CT scanning of the mediastinal window demonstrates large flaky fan shaped parenchymal shadows in the left middle-lower lung field, with ventilation shadows in them; and thickened pleura of the lateral chest wall. (g, h) Pathological examination showed staphylococcus aureus', 'hash': '00d7fc70edd23ceb6f012159d4bae8563ec20a036cc91fd99d91cdbc08f23126'}, {'image_id': '313891_1_En_17_Fig90_HTML', 'image_file_name': '313891_1_En_17_Fig90_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig90_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows in the lungs that fuse into mass in parenchymal shadows, with the hilum as the center and distributing bilaterally symmetric like butterfly wings. There are also multiple clustering cavities or singular large cavity in both lungs', 'hash': '6742eff5e10355ff74a6fe215cff47247a9d12856c453a35fd6d6742f8f0ac2e'}, {'image_id': '313891_1_En_17_Fig94a_HTML', 'image_file_name': '313891_1_En_17_Fig94a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig94a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a–f) CT scanning demonstrates multiple nodules and small cavities in honeycomb liked shadows and infiltrative parenchyma shadows in the right lung; flaky transparent areas (bullae of lung) in the right anterior margin of the heart and in the outer zone of the left lung near lateral chest wall', 'hash': '4bf177cdb556a837613a60231e962930fcd4acf34d7177f738cb57925ca917e1'}, {'image_id': '313891_1_En_17_Fig35b_HTML', 'image_file_name': '313891_1_En_17_Fig35b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig35b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates diffuse large flaky dense shadows in the right upper lung with transparent areas in them. (b–c) CT scanning of the pulmonary window demonstrates large flaky shadows with increased density in the right upper lung, with multiple satellite lesions scattering around. (d, e) CT scanning of the mediastinal window demonstrates large flaky parenchymal shadows in the right upper lung with air bronchogram sign as well as mediastinal lymphadenectasis', 'hash': '8b68f2c89884110f18b2b9641154ae26362875fb18db9a64b4320edd5c13bba4'}, {'image_id': '313891_1_En_17_Fig26a_HTML', 'image_file_name': '313891_1_En_17_Fig26a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig26a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '1bd3c2b9622fa99531543c1b9d456f58ff2945c6fa4bb44043fadb51fa9c8db6'}, {'image_id': '313891_1_En_17_Fig31_HTML', 'image_file_name': '313891_1_En_17_Fig31_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig31_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, fusion of some military shadows into patchy or mass liked shadow, diffusely distributed lung lesions', 'hash': '3bf8714e005c1ebc72eb46fac228838fd6436f0a1dd5d6a8bd085a14fddd1170'}, {'image_id': '313891_1_En_17_Fig69_HTML', 'image_file_name': '313891_1_En_17_Fig69_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig69_HTML.jpg', 'caption': '(a, b) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the medial basal segment of the right lower lung, irregular nodular shadows in the cavities, and surrounding fused miliary infiltration shadows', 'hash': 'db839a28accf7944530e9940a7c7afb2b7b3c7a4423308b863fae87f0c08c29a'}, {'image_id': '313891_1_En_17_Fig80_HTML', 'image_file_name': '313891_1_En_17_Fig80_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig80_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a, b) Anteroposterior and lateral DR demonstrate a huge dense mass shadow in the left lower lung, with clear boundary. (c) CT scanning of the pulmonary window demonstrates round liked high density shadow in the left lower lung near left chest wall, with even density. (d) CT scanning of the mediastinal window demonstrates round liked soft tissue density shadows in the left lower lung near left chest wall, with even density, lobulation, and surrounding thick spikes', 'hash': 'ea2ef199cee39dce2b4a8a06bcdcce274a6fd8796c2efbfaf940d6d05fe48c40'}, {'image_id': '313891_1_En_17_Fig43b_HTML', 'image_file_name': '313891_1_En_17_Fig43b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig43b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related tuberculous pleuritis. (a) DR demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (b) CT scanning of the pulmonary window demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (c) CT scanning of the mediastinal window demonstrates encapsulated fluid density shadow in the pleura of the right lateral chest wall', 'hash': '582e0f2e161551b97de13a60d6afed8cc613b9b04bfb136458587da830b2ecf0'}, {'image_id': '313891_1_En_17_Fig16_HTML', 'image_file_name': '313891_1_En_17_Fig16_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig16_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple fibrous cords liked shadows in lungs, multiple patchy parenchyma shadows and ground glass liked density shadows in both upper lobes, with multiple transparent areas in them. The bronchial walls are thickened in the anterior and posterior segments of the right upper lobe as well as in the lingual segment of the left lung', 'hash': '214979f5c447a9b40ebd0772cff663eb275052bf5fe8132456329ffacdc20c9c'}, {'image_id': '313891_1_En_17_Fig109_HTML', 'image_file_name': '313891_1_En_17_Fig109_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig109_HTML.jpg', 'caption': '(a, b) HIV/AIDS related lymphoma. (a, b) CT scanning demonstrates a huge soft tissue mass shadow in the left lateral chest wall, with a maximal size of about 7.7\u2009×\u200913.0 cm and occupying 30 sections with 8 mm in thickness of each section and with the upmost to the supraclavicular area and the bottom in the level of thoracic 12th vertebral body in the lower chest wall. There are also large quantity left pleural effusion and parenchymal changes of the left lower lobe with atelectasis. In the left chest cavity, large quantity liquid density shadows can be found, with compressed lung tissues to the hilum. By puncture and biopsy of the subaxillary mass, the diagnosis is defined as diffuse large B cell lymphoma', 'hash': '6d67a094843ca970dc50c93d50e7d1038c2a389c96e1772f425fa9dbc9d3a3ea'}, {'image_id': '313891_1_En_17_Fig19_HTML', 'image_file_name': '313891_1_En_17_Fig19_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig19_HTML.jpg', 'caption': '(a) Gross observation in autopsy demonstrates disseminated pulmonary tuberculosis, with grayish white military nodules in diffuse distribution in the lung tissues section. (b) It is demonstrated that mycobacteriumavium-intracellularcomplex infection in the lung tissue, with atypical tuberculosis nodules and acid-fast staining positive (left top). There are a subnodular giant cell, eosinophilic inclusion bodies in the nucleus and bradyzoites in cytoplasm of T. gondii. HE\u2009×\u2009100. (c) HE demonstrates mycobacteriumavium-intracellularcomplex infection, with atypical tuberculosis nodular changes, HE\u2009×\u2009200', 'hash': 'fac712a77d78563a8ebac012fe6c9f2f74ab72b1d36bf9e0c30462450f24c87d'}, {'image_id': '313891_1_En_17_Fig92a_HTML', 'image_file_name': '313891_1_En_17_Fig92a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig92a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs', 'hash': '981e19f8709c64fb0f850afd293a3dfdb67ec16a8d75e3f2bf19cd69116366cd'}, {'image_id': '313891_1_En_17_Fig41_HTML', 'image_file_name': '313891_1_En_17_Fig41_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig41_HTML.jpg', 'caption': 'HIV/AIDS related tuberculous pleuritis. DR demonstrates arch shaped dense shadows with higher exterior density and lower interior density in the right lower lung field and covered right edge of the heart', 'hash': '3381f76804304950a36ba44865a5651168e2f9b43c451a23d390d065bfc52e80'}, {'image_id': '313891_1_En_17_Fig56a_HTML', 'image_file_name': '313891_1_En_17_Fig56a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig56a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates huge round large flaky shadows with increased density in the left lower lung, enlarged and thickened hilum and covered right heart edge. (c, d) DR reexamination after treatment for 1 week demonstrates flocculent shadow in the left lower lung, improved than those before the treatment (a, b). (e) DR reexamination after treatment demonstrates flocculent liked shadows in the left lower lung, obviously improved than before the treatment (c, d)', 'hash': '8c2f7c50d0562920efd9257451f8cc2d4dda042eaa3768d3fb1455a7092edf94'}, {'image_id': '313891_1_En_17_Fig93a_HTML', 'image_file_name': '313891_1_En_17_Fig93a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig93a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates diffuse small cavity in honeycomb liked and infiltrative parenchyma shadows, with the hilum as the center to distribute bilaterally symmetric like butterfly wings; multiple honeycomb liked cavity shadows in both lungs. (e–h) CT scanning reexamination demonstrates large irregular thick-wall cavities in the right lung, surrounding scattering nodular, honeycomba liked and infiltrative shadows after anti-PM infection treatment for 3 months', 'hash': 'eb824267db9288c03e6cffae4cde8b6f47b3bda47dcad797ee4964b9011ac598'}, {'image_id': '313891_1_En_17_Fig46b_HTML', 'image_file_name': '313891_1_En_17_Fig46b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig46b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates large flaky dense shadows in the middle-outer zone of the left middle lung field, and narrowed left bronchus. (d–f) CT scanning demonstrates large flaky shadows with uneven density in the left lateral chest wall and even lower density shadow in them', 'hash': '97eaf0337e0212b917644691da5093524803db5d92384afd57bfc5803cb125e0'}, {'image_id': '313891_1_En_17_Fig39_HTML', 'image_file_name': '313891_1_En_17_Fig39_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig39_HTML.jpg', 'caption': '(a–d) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung, periphery crab feet liked or cords liked shadows due to pleural traction and satellite lesions. (c, d) CT scanning of the mediastinal window demonstrates round liked or triangle shaped thick wall cavities in the left upper lung, no nodules in the wall and peripheral nodular satellite lesions', 'hash': '614dd89032a813e240901110905f63b8b8d2530c6c7e27b0e6aab03ce47f7abb'}, {'image_id': '313891_1_En_17_Fig61_HTML', 'image_file_name': '313891_1_En_17_Fig61_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig61_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a) DR demonstrates large flaky shadow in the middle-outer zone of the left upper lung field. (b) DR demonstrates diffuse dense shadow in the left lung field, with round liked cavities shadows in them. (c–d) Reexamination after treatment demonstrates multiple cavities shadows in the middle-outer zone of the left upper lung field', 'hash': '29c84b1869c0cdabc91ee8822b014d024780586503e92fa0fdc6bed1d3b54b73'}, {'image_id': '313891_1_En_17_Fig88_HTML', 'image_file_name': '313891_1_En_17_Fig88_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig88_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a) The gross specimen demonstrates central necrotic pimples on the face. (b) Chest X-ray DR demonstrates cavities in the left upper lung, thickened lung markings in both lower lungs with accompanying multiple spots and flakes shadows. (c) Gastrointestinal barium meal radiology demonstrates left and downwards migration of the intestine due to compression. (d) Enhanced abdominal CT scanning demonstrates retroperitoneal enlarged lymph nodes that fuse into a huge mass, with ring shaped enhancement of the lymph nodes', 'hash': '72d6f61ccf9268cf07530a5a1e56a768d1d614ac854706838e783fa20f2cb2a1'}, {'image_id': '313891_1_En_17_Fig87_HTML', 'image_file_name': '313891_1_En_17_Fig87_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig87_HTML.jpg', 'caption': '(a) HE staining demonstrates lymph nodes, PM in the yeast phase, with sausage liked shape and obvious septa (HE\u2009×\u20091000). (b) GMS staining demonstrates clearly defined PMs (GMS\u2009×\u20091,000)', 'hash': '195e16d569e89c659459764942f07ae44cec9cd1fd8634e716178e34225094ab'}, {'image_id': '313891_1_En_17_Fig91a_HTML', 'image_file_name': '313891_1_En_17_Fig91a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig91a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–e) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of some lesions into honeycomb likes cavity shadows or plaque liked dense shadows. (f–h) CT scanning demonstrates large thick-wall cavity shadows in the right lung, surrounding plaque and round liked small cavity shadows and inflammatory infiltrative shadows', 'hash': '84aa8353e64cbf735c399fa64899ecd1e9b8a13620149a5aa662a21a423c07bf'}, {'image_id': '313891_1_En_17_Fig8b_HTML', 'image_file_name': '313891_1_En_17_Fig8b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig8b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates large flaky parenchyma shadows in both lungs which is more obvious in the middle and lower lobes of both lungs. There are also enlarged hilar shadows in both lungs and sharp both costophrenic angles. (b–g) CT scanning demonstrates large flaky parenchyma shadows in concentric and symmetrical distribution, bronchial shadows in them and thickened bronchial walls', 'hash': '812cc7d7992507bc22a7c06e518ff223d7e9ece757725f478a6f723b8ac030bf'}, {'image_id': '313891_1_En_17_Fig29_HTML', 'image_file_name': '313891_1_En_17_Fig29_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig29_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric and in even size and distribution. There are nodular shadows in the anterior segment of the right middle lung lobe with clear boundary', 'hash': '16cd873b8d84d3bbad635d9facea5407fe900b62efdd6f481449f4a433dfb6a0'}, {'image_id': '313891_1_En_17_Fig71_HTML', 'image_file_name': '313891_1_En_17_Fig71_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig71_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary aspergillosis infection. (a) The gross specimen demonstratesAspergillus abscess in the skin of the forearm. (b–d) CT scanning of the pulmonary window demonstrates multiple round liked nodular shadows and cavity shadows in both lungs, even thickness of cavity wall, and small nodular shadows in some cavities. (e) Pulmonary Aspergillus infection, demonstration purplish blue branches liked or grasses liked growth of hyphae, HE\u2009×\u2009400', 'hash': 'f0586168fbf7b2cd35205e1c807a3343af1ec5bac8dbe4f50308a570cd7d3552'}, {'image_id': '313891_1_En_17_Fig97_HTML', 'image_file_name': '313891_1_En_17_Fig97_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig97_HTML.jpg', 'caption': '(a) Gross observation of the fresh specimen in autopsy demonstrates pulmonary edema and congestion of cytomegalovirus pneumonia. (b) Gross observation of the formalin fixed specimen in autopsy demonstrates dark brown hard pulmonary tissues. (c, d) HE staining demonstrates large quantity cytomegalovirus inclusions in eagle eyes sign. (e) Immunohistochemical demonstrates HIV P24 antigen positive in macrophages of lung tissues (×400)', 'hash': '50e144edf7881be15e502fff23c2613760ac0172fe3ae6c56abf5ca1abf085b5'}, {'image_id': '313891_1_En_17_Fig20_HTML', 'image_file_name': '313891_1_En_17_Fig20_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig20_HTML.jpg', 'caption': '(a, b) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates enlarged right hilum in nodular dense shadows with peripheral thickened and blurry pulmonary markings, and no obvious abnormalities of the left hilum. (b) DR demonstrates smaller right hilum after treatment for 1 month', 'hash': '27213b483e54de634de857225fc93f6dc05eb5a729bc751141dea3866128c8ec'}, {'image_id': '313891_1_En_17_Fig6b_HTML', 'image_file_name': '313891_1_En_17_Fig6b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig6b_HTML.jpg', 'caption': '(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe', 'hash': 'ba6f221be2db1160358ae94e02b0125159adca1d9ac64bff84883eae8b614970'}, {'image_id': '313891_1_En_17_Fig17b_HTML', 'image_file_name': '313891_1_En_17_Fig17b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig17b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchymal shadows and fibrous cords liked shadows in both lungs which are more obvious in both lower lungs. The trachea and bronchi are unblocked, with enlarged hilar shadows in both lungs', 'hash': 'dba27067e12ab2a752ec8a543537f427156b1a18bdc04bffa3aedbe2d3b6e7bd'}, {'image_id': '313891_1_En_17_Fig113a_HTML', 'image_file_name': '313891_1_En_17_Fig113a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig113a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Kaposi’s sarcoma. (a–d) Chest CT scanning demonstrates scattered cloudy, mass and flake liked or nodular shadows with increased density. (e) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large thick stained nucleoli, which are in line with the diagnosis of Kaposi’s sarcoma. (f–i) Cured HIV/AIDS related Kaposi’s sarcoma. (f–i) Reexamination after treatment demonstrates absent lesions in both lungs, with clear lung fields', 'hash': '192d991df0d417610162aab90c8b0e07b4c19f1436faa752263e85c3efa0f3db'}, {'image_id': '313891_1_En_17_Fig77_HTML', 'image_file_name': '313891_1_En_17_Fig77_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig77_HTML.jpg', 'caption': 'HE staining demonstrates isseminated cryptococci, the Cryptococcus is stained red after mucin carmine staining of cryptococcus neoformans spores in lungs, (HE\u2009×\u2009200)', 'hash': '882060c6f53899fb225a20d7eb5fe410195beed0a7386dc233a4632284f4717f'}, {'image_id': '313891_1_En_17_Fig78_HTML', 'image_file_name': '313891_1_En_17_Fig78_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig78_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates multiple scattered nodular and miliary shadows in both lungs. (b–d) Chest CT scanning demonstrates multiple dense nodular shadows with different sizes in both lungs, with clear boundaries. They are intensively distributed in the dorsal segment and the largest one has a diameter of about 2 cm', 'hash': 'd60cf04886c28c578ee7940f50525d5141254a1a45a5b489d53a7ae5ae27fa53'}, {'image_id': '313891_1_En_17_Fig7b_HTML', 'image_file_name': '313891_1_En_17_Fig7b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig7b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates diffusely distributed shadows with increased density in both lungs that is more obvious in the middle and lower lungs. The hilar shadows in both lungs are enlarged. Both diaphragmatic surfaces and phrenic angles are blurry. (b–d) CT scanning demonstrates flaky shadows with increased density in both lungs, with parenchymal shadows in the lingular segment of left upper lobe and in the dorsal segments of both lower lobes and bronchial shadows in them. There are also thickened bronchial walls and enlarged hilar shadows in both lungs', 'hash': '47bf3b06e99aa6482027b30084d7445e95928d39923c99fd8fe93df39c899b2d'}, {'image_id': '313891_1_En_17_Fig30_HTML', 'image_file_name': '313891_1_En_17_Fig30_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig30_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs and fusion of some military shadows, which are bilaterally symmetric and in even size and distribution', 'hash': 'ab1d4160a6a23300146e331c7eee06edf886ca73ab4514f8a59b22d04d3c303f'}, {'image_id': '313891_1_En_17_Fig1_HTML', 'image_file_name': '313891_1_En_17_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig1_HTML.jpg', 'caption': '(a) Gross specimens’ observation demonstrates foamy liquid filling in the lung tissues. (b) HE demonstrates pneumocystis in the alveolar exudates, which can be stained black by silver methenamine staining, ×400. (c) HE demonstrates the foamy substance in the alveolar space, ×400', 'hash': 'a0082be568f7c995671d0461acf0cfe32c8c36a01dbf7badc28f3cc0ab407b75'}, {'image_id': '313891_1_En_17_Fig81_HTML', 'image_file_name': '313891_1_En_17_Fig81_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig81_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates thickened lung markings in both lungs and flaky blurry shadows in the left lower lung. (b, c) CT scanning demonstrates round liked nodular and small cavity shadows in the left upper and lower lung, with clear boundaries. (d–f) Pathology demonstrates transparent substrate in lung tissues and many bi-capsular cryptococci in cytoplasm', 'hash': '3e767fbaeda72c7b7b49df4ee9daa757367932f7623507185ca8453615c8de74'}, {'image_id': '313891_1_En_17_Fig58a_HTML', 'image_file_name': '313891_1_En_17_Fig58a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig58a_HTML.jpg', 'caption': '(a–i) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) CT scanning of the pulmonary window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (c, d) CT scanning of the mediastinal window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, pulmonary atelectasis and pleural effusion, with ventilation shadows in them. (e) CT scanning of the pulmonary window after the treatment demonstrates absence of the mass shadows in the left lower lung with transverse stripes shadows, obviously improved than previous findings (a, b). (f) HE staining demonstrates thickened alveolar septa and exudates from the alveolar cavity. (g) HE staining demonstrates massive bleeding in the alveolar cavity, large quantity erythrocytes and intact cell walls. (h) HE staining demonstrates phagocytized basophilic granules in the leukocytes. (i) HP staining demonstrates purplish red Rhodococcus equi in a shape of crescent in orange red sputum', 'hash': 'fcd60ca09d86084cb78d6b91f9b3e0a51e9f479a1c27837e18c9af0f809ef13d'}, {'image_id': '313891_1_En_17_Fig57_HTML', 'image_file_name': '313891_1_En_17_Fig57_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig57_HTML.jpg', 'caption': '(a, b)HIV/AIDS related Rhodococcus equi pneumonia. (a) CT scanning of the mediastinal window demonstrates soft tissue mass shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (b) CT scanning of the pulmonary window after the treatment demonstrates absence of the soft tissue mass shadows, and flocculent liked shadow in the left lower lung, obviously improved than previous findings (a)', 'hash': '9ac02a8eb30f8314fea4211fa5a4dbfa3863c422d30e78fcb26e8eaf44e36a42'}, {'image_id': '313891_1_En_17_Fig10_HTML', 'image_file_name': '313891_1_En_17_Fig10_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig10_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates large flaky and mass liked parenchyma shadows in both lungs which is more obvious in the right lung, bronchial shadows in them, and thickened bronchial walls in the middle lobe of the right lung', 'hash': 'dc81224c041dbc53a26ff01b3414f8c13098126861cf7cc0c7f10d80a7485e0c'}, {'image_id': '313891_1_En_17_Fig100_HTML', 'image_file_name': '313891_1_En_17_Fig100_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig100_HTML.jpg', 'caption': 'The structure of herpes simplex virus', 'hash': 'b0a88fbe1660ab4ddb94799e876d547c23b5686d12e31560768111a38bc71a45'}, {'image_id': '313891_1_En_17_Fig110a_HTML', 'image_file_name': '313891_1_En_17_Fig110a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110a_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '7392286985c0e8fefacf1282d1ef323dd6d64b0b536b667dfffbcbde5be28d3c'}, {'image_id': '313891_1_En_17_Fig5b_HTML', 'image_file_name': '313891_1_En_17_Fig5b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig5b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates patchy shadows with increased density in both lungs, with thickened hilar shadows in both lungs. (b–g) CT scanning demonstrates flaky ground glass liked density shadows in upper lungs and dorsal segment of both lungs, which is more obvious in the middle inner strips. There are extrapulmonary stripes transparent shadows, with some bronchial walls thickened and enlarged hilar shadows in both lungs', 'hash': 'fcd873302d30f9846ba865346820af2a06778c5dad1b50cc634281055ae78468'}, {'image_id': '313891_1_En_17_Fig47_HTML', 'image_file_name': '313891_1_En_17_Fig47_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig47_HTML.jpg', 'caption': '(a–e) HIV/AIDS related staphylococcus aureus pneumonia. (a) DR demonstrates large flaky dense shadows with increased density in the middle-inner zone of the left upper lung field, with blurry boundaries. The lung tissue are atelectatic and the mediastinum migrates leftwards. (b, c) CT scanning demonstrates large flaky dense shadows with increased density in the middle-inner zone of the left upper lung field, with blurry boundaries, with surrounding acinar or particle liked shadows that fuse into flaky shadows. (d, e) CT scanning demonstrates large flaky shadow of parenchymal changes in the middle-inner zone of the left upper lung field, with cyst liked transparent shadows and air bronchogram sign in them, as well as mediastinal lymphadenectasis', 'hash': '8e228a648d0d33ebe1db2bfa2fa7b6209cd113683b027d6ada34f161b809085a'}, {'image_id': '313891_1_En_17_Fig48_HTML', 'image_file_name': '313891_1_En_17_Fig48_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig48_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates broad band liked high density shadows in the right middle lung field, with air bronchogram sign in them. (d–f) CT scanning of the mediastinal window demonstrates broad band liked uneven parenchymal shadows in the right middle lung field, with uneven thickness of air bronchogram sign', 'hash': '6e700dc830efe216b64ed069dfb6440abf50854341b133bf0237be914bd5270f'}, {'image_id': '313891_1_En_17_Fig37_HTML', 'image_file_name': '313891_1_En_17_Fig37_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig37_HTML.jpg', 'caption': '(a, b) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a, b) DR demonstrates diffuse scattering patchy shadows with increased density, and oval thin wall cavity shadows in the right middle lung field', 'hash': 'edc3511f0cc30005fb5999c1fe7033024176b0e1b8fee607763caef6a0d9abe2'}, {'image_id': '313891_1_En_17_Fig38_HTML', 'image_file_name': '313891_1_En_17_Fig38_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig38_HTML.jpg', 'caption': '(a–d) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in both upper lungs, peripheral crab feet liked or cords liked shadows due to pleural traction with cavity shadows in them and periperal satellite lesions. (b–d) CT scanning of the mediastinal window demonstrates round liked mass shadows with high density in the cavities of the left upper lung, surrounding transparent shadows, no nodules in the walls and surrounding nodular satellite lesions. By pathological examination, the diagnosis is defined as chronic fibrous cavity pulmonary tuberculosis complicated by Aspergillus infection', 'hash': '0317a9a78d280af1069a5b797b63c3817f47607eb13976214ed710d247081a7c'}, {'image_id': '313891_1_En_17_Fig65b_HTML', 'image_file_name': '313891_1_En_17_Fig65b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig65b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related allergic pulmonary Aspergillus infection. (a–f) CT scanning of the pulmonary window demonstrates thickened central pulmonary markings in both lungs, which is turtuous and deranged with fingertip infiltration shadows. (g) DR demonstrates hyperinflation of the right lung, increased and thickened pulmonary markings and ground glass liked shadows with increased density in the right lower lung and left lung lobe', 'hash': '44f320a9216b7a9905eaaa045a44b4be59372433c9737f0ee8ded7c443134eaa'}, {'image_id': '313891_1_En_17_Fig9_HTML', 'image_file_name': '313891_1_En_17_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig9_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates large flaky parenchyma shadows in both lungs, with transparent areas in some foci. The trachea and bronchi are unblocked, with thickened bronchial walls in the middle and lower lobes', 'hash': '26b10397cecf70e4665c1abb0f2501e939a6e5d219f395c3484c7a44dae78681'}, {'image_id': '313891_1_En_17_Fig76a_HTML', 'image_file_name': '313891_1_En_17_Fig76a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig76a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning demonstrates diffuse scattered thin ground glass liked, patchy, flaky blurry shadows and cords liked shadows in both lungs, with blurry boundaries and uneven density; scattered nodular shadows in different sizes; more lesions in both upper lobes and the right middle lobe; flaky parenchyma shadows in the apical and posterior segments of right upper lobe, with air bronchogram sign in them; unobstructed opening of bronchi as well as lobar and segmental bronchi without stenosis and obstruction; lymphadenectasis in the right hilar region; detected Aspergillus fumigatus by sputum culture. (e, f) Culture for 72 h, lactic acid gossypol blue staining and microscopic observation at ×200 and ×400 demonstrate short column liked conidial head, smooth wall of conidiophores, flask-shaped top capsule and monolayer microconidiophores. (g) Culture in Paul’s medium demonstrates dark green colored colonies', 'hash': '79dde610127d242cc7f1f29fc98dd50c426df080c95629396102af54f31872c9'}, {'image_id': '313891_1_En_17_Fig86_HTML', 'image_file_name': '313891_1_En_17_Fig86_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig86_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary candida infection. (a–d) CT scanning demonstrates thickened and deranged lung markings in both lungs, diffuse small flaky or patchy shadows, fusion of some small shadows into large flaky dense shadows, with blurry boundaries, enlarged hilum and blurry structures', 'hash': 'bb5525804e3b5cc6588115cd2813109845df9b4314974ab2b55c40298ed6968a'}, {'image_id': '313891_1_En_17_Fig89_HTML', 'image_file_name': '313891_1_En_17_Fig89_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig89_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows in the lungs that fuse into mass with parenchymal shadows, with the hilum as the center and distributing bilaterally symmetric like butterfly wings. There are also multiple clustering cavities or singular large cavity in both lungs', 'hash': 'cfd1927b986a8aba818bf96427711a3743dd07195a83b88e195837af405aae79'}, {'image_id': '313891_1_En_17_Fig60_HTML', 'image_file_name': '313891_1_En_17_Fig60_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig60_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a) DR demonstrates huge sphere liked mass shadow in the middle-outer zone of the right lower lung field, with cavities shdows in them. (b–d) CT scanning demonstrates triangular dense shadow in the middle-outer zone of the right lower lung field, with its apex pointing to the hilum and round liked cavities shadows in them. (e) Reexamination after the treatment demonstrates shrinkage of the huge sphere liked mass shadow in the middle-outer zone of the right lower lung field, with closure of the cavities', 'hash': '9020727e51b9a8522ea37dd579ce73bd9a417d327bcb313836c96e1fa3bd209f'}, {'image_id': '313891_1_En_17_Fig2b_HTML', 'image_file_name': '313891_1_En_17_Fig2b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig2b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered miliary increased density shadows in both lungs, with even size, density and distribution. The shadows of both hila are dense, with sharp both costophrenic angles. (b–f) CT scanning demonstrates scattered miliary nodular shadows in both lungs, which is more obviously in the middle pulmonary strip and with quite even size and density. Trachea and bronchi are unblocked', 'hash': 'ab808d6adb73be9c9efd977cd27ef54cace943f5143068db354c7d287374a50d'}, {'image_id': '313891_1_En_17_Fig13b_HTML', 'image_file_name': '313891_1_En_17_Fig13b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig13b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, transparent areas in them and unblocked trachea and bronchi', 'hash': '2f728d8163ffe4c88ed77f38f8d2e52cb2281b7f3a54af1e9ef328c17a26db3e'}, {'image_id': '313891_1_En_17_Fig28_HTML', 'image_file_name': '313891_1_En_17_Fig28_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig28_HTML.jpg', 'caption': '(a–b) HIV/AIDS related miliary tuberculosis. (a) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric and in even size and distribution. (b) CT scanning of the mediastinal window demonstrates round liked nodular shadows in the right lower lung. CT guided puncture for biopsy is performed to define the diagnosis', 'hash': '1ae71db3f6eebb2e460b8f3b777873d5e7fcf066436bf3a85ef8123aff3f39a9'}, {'image_id': '313891_1_En_17_Fig105b_HTML', 'image_file_name': '313891_1_En_17_Fig105b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig105b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary toxoplasmosis. (a–d) CT scanning demonstrates thickened pulmonary markings in both lungs, which can be enhanced to extend into the middle and outer zones of lungs, in grid liked appearance that is more obvious in the dorsal segment of the lungs. (e) It is demonstrated to have clustering toxoplasma tachyzoites', 'hash': '78ad5a602c243399be530b578f5858d7393984c75f2f978c1dd02f12b26b8836'}, {'image_id': '313891_1_En_17_Fig99_HTML', 'image_file_name': '313891_1_En_17_Fig99_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig99_HTML.jpg', 'caption': '(a, b) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates enlarged right hilus, thickened and deranged lung markings. (b) Plain CT scanning demonstrates mass shadows in the right hilus, spots shadows in the right middle and lower lobes, and patchy shadows in the lingual segment of the left lung', 'hash': '996d2e340f8971525deb4ef2a9312fe4a696f4d7f6bf28ca091e8c767b96b1d4'}, {'image_id': '313891_1_En_17_Fig3b_HTML', 'image_file_name': '313891_1_En_17_Fig3b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig3b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy and scattered miliary increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of the lower lung field, with some fused in thin cloudy shadows', 'hash': '8c1d9dac035274e484303c9deb64a07fed7806c66acaf49b860164feb6d461fc'}, {'image_id': '313891_1_En_17_Fig70_HTML', 'image_file_name': '313891_1_En_17_Fig70_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig70_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window demonstrates a huge cavity shadow in the dorsal segment of the right lower lung, large nodular shadows in it, liquid gas level in the basal cavity, and the evenly thick wall. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates a huge cavity shadow in the dorsal segment of the left lung, multiple large nodular shadows in it, and involved pleura of the lateral chest wall', 'hash': '967426acae68b8d57372efde07d76dd6ad696b10cc5bb64fb67bd9af43a1b0c8'}, {'image_id': '313891_1_En_17_Fig108_HTML', 'image_file_name': '313891_1_En_17_Fig108_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig108_HTML.jpg', 'caption': 'HIV/AIDS related lymphoma. DR demonstrates widened upper middle mediastinum in a dense shadow, enlarged and thickened hilum, thickened and blurry pulmonary markings with diffuse ground glass liked changes', 'hash': '449c992b619237febe63b1617b26f78de511c69c5d1c86ddbd66631790a3e3ce'}, {'image_id': '313891_1_En_17_Fig18_HTML', 'image_file_name': '313891_1_En_17_Fig18_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig18_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates multiple patchy shadows with increased density in both lungs which are more obvious in both middle and lower lungs. The hilar shadows in both lungs are enlarged, with sharp both costophrenic angles. (b–d) CT scanning demonstrates multiple patchy and mass liked parenchyma shadows in both lungs, ground glass density shadows in the apical segment of both upper lobes, transparent areas in the medial segment of the right middle lobe as well as in the lingual segment of the left upper lobe, and unobstructed trachea and bronchi', 'hash': '18239548bfc8a180d3460173e2f66f27c6ff38e464607d7ec3eb2a837a1382c9'}, {'image_id': '313891_1_En_17_Fig67b_HTML', 'image_file_name': '313891_1_En_17_Fig67b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig67b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows. (e–h) Reexamination of the pulmonary window after 3 months treatment demonstrates multiple scattered round liked nodular shadows and thick wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows which obviously increase and enlarge compared to previous lesions, with accompanying infiltration shadows around the lesions', 'hash': 'f70faec5b814f1fa9555182e0f5414a33838b2496e4da16dc69e0c237676eb30'}, {'image_id': '313891_1_En_17_Fig115a_HTML', 'image_file_name': '313891_1_En_17_Fig115a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig115a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lung cancer. (a–f) CT scanning demonstrates diffuse soft tissue density shadows in left upper lung, round liked mass shadows in the middle lung field, thickened pleura in the lateral chest wall with adhesion, and strip liked liquid density shadows', 'hash': '08de7c80ca9fdc7641723bbb9689498f65631a1a2ee1f499cda653be3ea3d358'}, {'image_id': '313891_1_En_17_Fig40_HTML', 'image_file_name': '313891_1_En_17_Fig40_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig40_HTML.jpg', 'caption': '(a, b) HIV/AIDS related endobronchial tuberculosis. (a, b) Chest CT scanning demonstrates narrowed left major bronchus, irregular thickening of the brounchial wall, multiple irregular flaky, patchy and military shadows in the posterior apical, anterior and lingual segments of the left upper lung. Bronchobierscopy demonstrates narrowed left major bronchus, which is possibly caused by endobronchial tuberculosis', 'hash': '4e416b52d4cb1a2790ee8ad419d525b4e0b37740624cb136f4f5d66c98344651'}, {'image_id': '313891_1_En_17_Fig106b_HTML', 'image_file_name': '313891_1_En_17_Fig106b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig106b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related lymphoma. (a–b) DR demonstrates enlarged and thickened left hilum in a huge mass shadow. High KV demonstrates a huge mass shadow in the hilum. (c–h) CT scanning of the pulmonary window demonstrates a huge high density mass shadow in the left hilum, surrounding nodular fusion shadows in the lung tissues. CT scanning of the mediastinal window demonstrates a huge high density mass shadow in the left hilum, with air bronchogram sign in the shadow', 'hash': '157c65f2ce36513c7bad3d16abf703fde23671a6d95e1da5b62342efd5b516bb'}, {'image_id': '313891_1_En_17_Fig75a_HTML', 'image_file_name': '313891_1_En_17_Fig75a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig75a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval or sphere shaped nodular shadows in the cavities with smooth boundaries. (e, f) Reexamination after treatment demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval nodular shadows in the cavity with smooth boundaries. Compared to the previous imaging findings, the lesions are shrunk, with improved surrounding infiltration', 'hash': 'd2c91d61cbf8a801eed1951a78b54e9b966e9be37aee83d7582af7a496143832'}, {'image_id': '313891_1_En_17_Fig66b_HTML', 'image_file_name': '313891_1_En_17_Fig66b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig66b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates large flaky shadows with increased density in the right upper lung, with blurry boundaries; round liked or sphere shaped mass shadows in the right lower lung, with uneven density. (b–e) CT scanning of the pulmonary window demonstrates multiple round liked thick-wall cavities in the dorsal segment of the right lower lung, with small nodular shadow adhering on the cavity wall; and surrounding small nodular shadows and infi ltration shadows. (f, g) Coronal CT scanning reconstruction demonstrates a huge thick-wall cavity in the right upper lung, with irregular thickness of the wall; round liked cavity shadows in the right lower lung, with thick and multilocular walls; and flaky shadows with increased density in the outer zone of the left lower lung', 'hash': 'fe0cc9e767d47fe24d043db5792869e260b44f40097a6c4d26c923e91ef70b0b'}, {'image_id': '313891_1_En_17_Fig98a_HTML', 'image_file_name': '313891_1_En_17_Fig98a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig98a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates thickened lung markings in both lungs, which extend to the outer zone of the lungs. (b) DR demonstrates thickened and deranged lung markings in both lungs with nodular blurry shadows; and cloudy shadows in lung fields. (c, d) CT scanning demonstrates thickened lung markings in both lungs, with diffuse nodular shadows; and cloudy changes in lung fields. (e) HE staining demonstrates cytomegalovirus inclusions', 'hash': 'adcabf812efa2a551bb7a968e7cf0afcc7677ffb9adf3d1a40a65675496e4552'}, {'image_id': '313891_1_En_17_Fig50_HTML', 'image_file_name': '313891_1_En_17_Fig50_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig50_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Staphylococcus aureus pneumonia. (a) DR demonstrates large flaky dense shadow in the right middle-upper lung field, with blurry boundary. (b, c) CT scanning demonstrates large flaky dense shadow in the right middle upper lung field, with blurry boundary. (d, e) CT scanning demonstrates large flaky dense shadow in the right middle upper lung field, with cystic transparent area in it. (f) Reexamination demonstrates obviously improved pulmonary lesions in the right lung after anti-bacteria treatment for 3 weeks', 'hash': 'bb5e00f8d7a7c6c4308ca4e5024daa75df1bf9a0a88359faa7e2ee91a6c5f156'}, {'image_id': '313891_1_En_17_Fig114a_HTML', 'image_file_name': '313891_1_En_17_Fig114a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig114a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related Kaposi’s sarcoma. (a–d) CT scanning demonstrates scattered cloudy mass and flakes liked or nodular shadows with increased density in both lungs with uneven density and unclear boundaries, fusion and parenchymal changes of some lesions, more lesions in the lower lobe of both lungs and mostly with parenchymal changes. (e, f) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large and thick stained nucleoli, which are in line with the manifestations of Kaposi’s sarcoma. (g, h) Immunohistochemical demonstrates positive of C3 and C4', 'hash': '5d7437deda7758de05e56f8172703b4659fa4eeebdc50c92456867e7bfdb2691'}, {'image_id': '313891_1_En_17_Fig107b_HTML', 'image_file_name': '313891_1_En_17_Fig107b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig107b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related lymphoma. (a–e) CT scanning of the pulmonary and mediastinal windows demonstrates multiple round liked nodular shadows with increased density in both lung fields, with clear boundaries; large soft tissue mass shadows in the right lower lung, with slightly lobulated boundaries and spikes. (f–i) CT scanning of the pulmonary and mediastinal windows for reexamination after radiation therapy demonstrates shrinkage of intrapulmonary nodules and masses', 'hash': 'a7c148d3f71f853c603d1730a516c4b571960bd1e6296b96b6418a73f3663e33'}] | {'313891_1_En_17_Fig1_HTML': ['By naked eyes observation, there are extensive and diffuse invasion of lungs, which is soft like waterlogged sponge and in milky white with black spots. The filled foamy substance in the alveoli and bronchioles is a mixture of necrotic fungus and immunoglobulin. The alveolar septum has infiltration of plasma cells and lymphocytes, resulting in thickened alveolar septa up to 5–20 times as the normal thickness that occupy 3/4 of the entire lung volume. The cysts are firstly located in the macrophage cytoplasm of the alveolar septa. Subsequently, the alveolar cells containing cysts sheds off into the alveolar space. After the rupture of the cystic wall, sporozoite is discharged to turn into free trophozoites, which gains its access into the alveolar space. The alveolar exudates include plasma cells, lymphocytes and histocytes (Fig. <xref rid="313891_1_En_17_Fig1_HTML" ref-type="fig">17.1a–c</xref>).\n).\nFig. 17.1(a) Gross specimens’ observation demonstrates foamy liquid filling in the lung tissues. (b) HE demonstrates pneumocystis in the alveolar exudates, which can be stained black by silver methenamine staining, ×400. (c) HE demonstrates the foamy substance in the alveolar space, ×400\n'], '313891_1_En_17_Fig19_HTML': ['If the necrotic lesions erode the blood vessels, tubercle bacilli can cause systemic miliary tuberculosis along with blood flow, including brain, bones and kidneys. Large quantity sputum containing tubercle bacilli gains its access into the gastrointestinal tract. It can also cause intestinal tuberculosis and peritoneal tuberculosis. Pulmonary tuberculosis can cause tuberculosis pleurisy via direct spreading to the pleura (Fig. <xref rid="313891_1_En_17_Fig19_HTML" ref-type="fig">17.19a–c</xref>).\n).\nFig. 17.19(a) Gross observation in autopsy demonstrates disseminated pulmonary tuberculosis, with grayish white military nodules in diffuse distribution in the lung tissues section. (b) It is demonstrated that mycobacteriumavium-intracellularcomplex infection in the lung tissue, with atypical tuberculosis nodules and acid-fast staining positive (left top). There are a subnodular giant cell, eosinophilic inclusion bodies in the nucleus and bradyzoites in cytoplasm of T. gondii. HE\u2009×\u2009100. (c) HE demonstrates mycobacteriumavium-intracellularcomplex infection, with atypical tuberculosis nodular changes, HE\u2009×\u2009200\n'], '313891_1_En_17_Fig45_HTML': ['Pneumonia caused by inhaled staphylococcus aureus through the respiratory tract often shows lesions in the large lobes or extensive fusion of bronchopneumonia lesions. Bronchial and alveolar rupture allows gas to enter the pulmonary interstitium, which is communicated with the bronchi. In the cases of bronchiolar blockage by necrotic tissues or pus, the one-way valve effect is formed to cause tension pulmonary emphysema. In the cases with superficial pulmonary emphysema with excessively high tension, it ruptures to form pneumothorax or pyopneumothorax, as well as bronchooleural fistula (Fig. <xref rid="313891_1_En_17_Fig45_HTML" ref-type="fig">17.45a, b</xref>).\n).\nFig. 17.45(a, b) HIV/AIDS related Staphylococcus aureus pneumonia. (a) Gross specimen observation demonstrates bilateral purplish brown lesions, patchy white infiltration at the base of the lungs. (b) HE staining demonstrates alveolar diffuse lesions, exudation of the serous fluid and inflammatory cells in the alveolar cavity, and alveolar wall congestion\n'], '313891_1_En_17_Fig64_HTML': ['Aspergillus commonly violates bronchus and lung, with involvements of rhinal sinuses, external auditory canal, eye and skin. Otherwise, it disseminates to organs of the body along with blood flow. The early lesions are diffuse infiltrative and exudative changes. And advanced lesions are necrosis, pyogenesis or granuloma. Large quantity hyphae can be found in the lesions. The hyphae penetrate the blood vessels to cause vasculitis, perivascular inflammation and thrombosis. And thrombosis can cause ischemia and necrosis of the tissue. According to the pathological changes and imaging findings, it can be divided into three major types: vascular invasion type, bronchopneumonia type and allergic bronchopulmonary aspergillosis type. (1) The vascular invasion type is the result caused by toxins released in the process of aspergillus spreading extensively from the primary focus to the lungs. Vascular infiltration of the pulmonary parenchyma and coagulative necrosis are believed to be the cause of vascular occlusion and pulmonary infarction. (2) Bronchopneumonia type is acute bronchitis caused by inhalation of Aspergillus spores. In the cases of hyphae invasion into the lung tissues, extensive infiltrative pneumonia or focal granuloma are resulted in. It can also cause necrosis, pyogenesis and multiple small abscesses. Spherical pulmonary aspergillosis is often secondary to bronchiectasis, tuberculosis, carcinous cavity and other lung diseases. Mycelia multiply and gather in the cavities of the lungs to form a spherical mass with fibrin and mucosal cells, which are called aspergillar glomera, which do not invade the lung tissue. (3) Allergic bronchopulmonary aspergillosis type is the proliferation and germination of inhaled Aspergillus spore in the airway, often showing obvious related mucosal lesions and eventually resulting in bronchiectasis (Fig. <xref rid="313891_1_En_17_Fig64_HTML" ref-type="fig">17.64a–c</xref>).\n).\nFig. 17.64(a) Gross observation demonstrates dark brown lungs in appearance. (b, c) Thology demonstrates hemorrhage and edema of the lung tissue and focal necrosis, with large quantity Aspergillus hyphae and spores in the surrounding area of the necrosis (Combined with pulmonary CMV infection)\n'], '313891_1_En_17_Fig77_HTML': ['In the early stage of cryptococcal infection, only a mild inflammatory reaction or diffuse infiltrative exudative changes occur. But in the advanced stage, necrosis, suppuration or granuloma is formed. Large quantity hyphae can be found in the focus. In the cases with hyphae penetrating the blood vessels, vasculitis, perivascular inflammation and thrombosis occur. And thrombosis leads to ischemia and necrosis of the tissue (Fig. <xref rid="313891_1_En_17_Fig77_HTML" ref-type="fig">17.77</xref>).\n).\nFig. 17.77HE staining demonstrates isseminated cryptococci, the Cryptococcus is stained red after mucin carmine staining of cryptococcus neoformans spores in lungs, (HE\u2009×\u2009200)\n'], '313891_1_En_17_Fig97_HTML': ['Cytomegalovirus pneumonia has extensive pathological changes in the lungs. Pathologically, it shows interstitial pneumonia, with the lesions randomly blood borne distributing in the lungs. The distribution can be diffuse, panlobular or focal. The target cells of pathological changes include alveolar cells and macrophages. Diffused pulmonary interstitial edema and fibrosis as well as alveolar swelling, focal necrosis, bleeding and hyperplasia occur after CMV infections to cause hypoxemia. Gross observation of fresh specimens demonstrates pulmonary surface edema and flaky blooding spots. Fixed specimens demonstrate brown hard lung tissues. Under a microscope, pulmonary interstitial congestion as well as infiltration of lymphocytes and mononuclear cells can be found, with the involved epithelial cells enlarged. In the pulmonary interstitium and alveoli, there are intranuclear inclusions, cytoplasmic inclusions and fluid containing abundant proteins. The classical intranuclear inclusions can be found in the cells, purplish red or purplish blue, round or oval, with surrounding halos in eagle eyes sign. Atypical cytomegalic inclusions in cells are slender, long and round liked with abundant cytoplasm and accentric nucleolus, which are blurry, unclear and atypical (Fig. <xref rid="313891_1_En_17_Fig97_HTML" ref-type="fig">17.97a–e</xref>). Immunohistochemitry demonstrates HIV P24 antigen positive.\n). Immunohistochemitry demonstrates HIV P24 antigen positive.\nFig. 17.97(a) Gross observation of the fresh specimen in autopsy demonstrates pulmonary edema and congestion of cytomegalovirus pneumonia. (b) Gross observation of the formalin fixed specimen in autopsy demonstrates dark brown hard pulmonary tissues. (c, d) HE staining demonstrates large quantity cytomegalovirus inclusions in eagle eyes sign. (e) Immunohistochemical demonstrates HIV P24 antigen positive in macrophages of lung tissues (×400)\n']} | HIV/AIDS Related Respiratory Diseases | [
"HIV/AIDS related pneumocystis carnii pneumonia (PCP)",
"HIV/AIDS related pulmonary bacterial infections",
"HIV/AIDS related pulmonary fungal infections",
"HIV/AIDS related pulmonary virus infections",
"HIV/AIDS related pulmonary parasitic diseases",
"HIV/AIDS related pulmonary neoplasm"
] | None | 1380524400 | None | null | other | PMC7121050 | null | null | [
""
] | Radiology of HIV/AIDS. 2013 Sep 30;:377-535 | NO-CC CODE |
|
(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe | 313891_1_En_17_Fig6a_HTML | 7 | 235548456c9bf72727a05a91fa6893d8a478f8f715c022d6b579d4a9188da366 | 313891_1_En_17_Fig6a_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
782,
288
] | [{'image_id': '313891_1_En_17_Fig115b_HTML', 'image_file_name': '313891_1_En_17_Fig115b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig115b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lung cancer. (a–f) CT scanning demonstrates diffuse soft tissue density shadows in left upper lung, round liked mass shadows in the middle lung field, thickened pleura in the lateral chest wall with adhesion, and strip liked liquid density shadows', 'hash': '37ffef88f4c6dffdd2849b9994419efe1bf8f369ad111d82071f2f004a9fa43f'}, {'image_id': '313891_1_En_17_Fig106a_HTML', 'image_file_name': '313891_1_En_17_Fig106a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig106a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related lymphoma. (a–b) DR demonstrates enlarged and thickened left hilum in a huge mass shadow. High KV demonstrates a huge mass shadow in the hilum. (c–h) CT scanning of the pulmonary window demonstrates a huge high density mass shadow in the left hilum, surrounding nodular fusion shadows in the lung tissues. CT scanning of the mediastinal window demonstrates a huge high density mass shadow in the left hilum, with air bronchogram sign in the shadow', 'hash': '1ff6a74f6517ed666fda8da1eb38cd58b7d92c3687c533350df4caf4cb7ba7d7'}, {'image_id': '313891_1_En_17_Fig67a_HTML', 'image_file_name': '313891_1_En_17_Fig67a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig67a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows. (e–h) Reexamination of the pulmonary window after 3 months treatment demonstrates multiple scattered round liked nodular shadows and thick wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows which obviously increase and enlarge compared to previous lesions, with accompanying infiltration shadows around the lesions', 'hash': '75b2dd5456ce09da0ace0b9787ea5a36d49c80e174314762343564032297b51c'}, {'image_id': '313891_1_En_17_Fig14_HTML', 'image_file_name': '313891_1_En_17_Fig14_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig14_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, mass and flakes of parenchymal shadows in the posterior segment of the right upper lobe and in the dorsal segment of both lower lobes which is more obvious in the right lung, and bronchial shadows in them', 'hash': 'bc4343d2071f380a05855c1e658dc05d90d8ae123e988cfe12c3e65526b3336c'}, {'image_id': '313891_1_En_17_Fig104_HTML', 'image_file_name': '313891_1_En_17_Fig104_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig104_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymphoid interstitial pneumonia. (a–f) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs in reticular appearance, with accompanying multiple small nodular shadows, fusion of some nodules into flaky shadows, and ground glass liked changes in the lung fields', 'hash': '4883f041ed6e05ad0ce9ee6734fea4171aae151209ba36cbce94c8434c86f174'}, {'image_id': '313891_1_En_17_Fig98b_HTML', 'image_file_name': '313891_1_En_17_Fig98b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig98b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates thickened lung markings in both lungs, which extend to the outer zone of the lungs. (b) DR demonstrates thickened and deranged lung markings in both lungs with nodular blurry shadows; and cloudy shadows in lung fields. (c, d) CT scanning demonstrates thickened lung markings in both lungs, with diffuse nodular shadows; and cloudy changes in lung fields. (e) HE staining demonstrates cytomegalovirus inclusions', 'hash': '489286db9d367c09fbc842e4d1ba093d9caa6ded75760e9e1a70e05a86f43979'}, {'image_id': '313891_1_En_17_Fig53_HTML', 'image_file_name': '313891_1_En_17_Fig53_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig53_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) Anteroposterior and lateral DR demonstrates enlarged and thickened left hilum, and large flaky blurry shadows with increased density in the left lower lung. (c, d) Reexamination demonstrates normal lungs after antibiotic treatment', 'hash': 'd9cd861c21f1100d02e20014901c7e4a9a9bcad2e4ddcd3c731b50168d8782be'}, {'image_id': '313891_1_En_17_Fig114b_HTML', 'image_file_name': '313891_1_En_17_Fig114b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig114b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related Kaposi’s sarcoma. (a–d) CT scanning demonstrates scattered cloudy mass and flakes liked or nodular shadows with increased density in both lungs with uneven density and unclear boundaries, fusion and parenchymal changes of some lesions, more lesions in the lower lobe of both lungs and mostly with parenchymal changes. (e, f) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large and thick stained nucleoli, which are in line with the manifestations of Kaposi’s sarcoma. (g, h) Immunohistochemical demonstrates positive of C3 and C4', 'hash': '586be9acfd2434fad0db1a2ffaba9ac72eb8eb799b76acdaeac2730c48c45020'}, {'image_id': '313891_1_En_17_Fig107a_HTML', 'image_file_name': '313891_1_En_17_Fig107a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig107a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related lymphoma. (a–e) CT scanning of the pulmonary and mediastinal windows demonstrates multiple round liked nodular shadows with increased density in both lung fields, with clear boundaries; large soft tissue mass shadows in the right lower lung, with slightly lobulated boundaries and spikes. (f–i) CT scanning of the pulmonary and mediastinal windows for reexamination after radiation therapy demonstrates shrinkage of intrapulmonary nodules and masses', 'hash': '4ca6acd1461c3d7b80869d7d33bd1a3d91ecd1a0dc1b5c7baecc0bfbcf817449'}, {'image_id': '313891_1_En_17_Fig75b_HTML', 'image_file_name': '313891_1_En_17_Fig75b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig75b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval or sphere shaped nodular shadows in the cavities with smooth boundaries. (e, f) Reexamination after treatment demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval nodular shadows in the cavity with smooth boundaries. Compared to the previous imaging findings, the lesions are shrunk, with improved surrounding infiltration', 'hash': 'b1a96158009afcb5e673cf31f9243ca598c763c294bbdc7479a918fb36b031e8'}, {'image_id': '313891_1_En_17_Fig25d_HTML', 'image_file_name': '313891_1_En_17_Fig25d_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25d_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '1e7425ad1ac60b1c612434d02bbe7d48ba0fb82e0642b09b8771b4fea9a7a4c2'}, {'image_id': '313891_1_En_17_Fig66a_HTML', 'image_file_name': '313891_1_En_17_Fig66a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig66a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates large flaky shadows with increased density in the right upper lung, with blurry boundaries; round liked or sphere shaped mass shadows in the right lower lung, with uneven density. (b–e) CT scanning of the pulmonary window demonstrates multiple round liked thick-wall cavities in the dorsal segment of the right lower lung, with small nodular shadow adhering on the cavity wall; and surrounding small nodular shadows and infi ltration shadows. (f, g) Coronal CT scanning reconstruction demonstrates a huge thick-wall cavity in the right upper lung, with irregular thickness of the wall; round liked cavity shadows in the right lower lung, with thick and multilocular walls; and flaky shadows with increased density in the outer zone of the left lower lung', 'hash': 'efec688fc6d0fd9fc9188edcc4a4bb040754e9c9e3261fcacec068f3bfd0252f'}, {'image_id': '313891_1_En_17_Fig63_HTML', 'image_file_name': '313891_1_En_17_Fig63_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig63_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Rhodococcus equi pneumonia. (a) Pulmonary CT scanning demonstrates a mass shadow in the lateral segment of the right middle lobe in size of 4.7\u2009×\u20093.7\u2009×\u20093.2 cm with uneven density and lace liked boundary, and small bubbles shadows in it. By both sputum culture and lung tissue culture, Rhodococcus equi can be detected. (b, c) Pathological biopsy and HE staining demonstrate inflammatory pseudotumor. (d, e) Immunohistochemistry demonstrates Rhodococcus equi antibody positive. (f) Reexamination after treatment demonstrates obvious shrinkage of the original lung lesions', 'hash': 'ac97b316499d751a48d8b861962da376a39c7ff11d2554ed957c226224dc65b6'}, {'image_id': '313891_1_En_17_Fig2a_HTML', 'image_file_name': '313891_1_En_17_Fig2a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig2a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered miliary increased density shadows in both lungs, with even size, density and distribution. The shadows of both hila are dense, with sharp both costophrenic angles. (b–f) CT scanning demonstrates scattered miliary nodular shadows in both lungs, which is more obviously in the middle pulmonary strip and with quite even size and density. Trachea and bronchi are unblocked', 'hash': 'ec4f2f75b5bb59b2cb13f016c2ea6714bdc3c908077c2697af2218aa485876b7'}, {'image_id': '313891_1_En_17_Fig13a_HTML', 'image_file_name': '313891_1_En_17_Fig13a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig13a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, transparent areas in them and unblocked trachea and bronchi', 'hash': '7d26c2f94a34f3ff7c4f64d485fe29e114936d0f4db53489ee88148a1a6fc8bf'}, {'image_id': '313891_1_En_17_Fig65a_HTML', 'image_file_name': '313891_1_En_17_Fig65a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig65a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related allergic pulmonary Aspergillus infection. (a–f) CT scanning of the pulmonary window demonstrates thickened central pulmonary markings in both lungs, which is turtuous and deranged with fingertip infiltration shadows. (g) DR demonstrates hyperinflation of the right lung, increased and thickened pulmonary markings and ground glass liked shadows with increased density in the right lower lung and left lung lobe', 'hash': '6fa5ade163d7465c0dc3eb89ebc58d57b98674fc2680824cc5a81c478b81fbc4'}, {'image_id': '313891_1_En_17_Fig76b_HTML', 'image_file_name': '313891_1_En_17_Fig76b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig76b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning demonstrates diffuse scattered thin ground glass liked, patchy, flaky blurry shadows and cords liked shadows in both lungs, with blurry boundaries and uneven density; scattered nodular shadows in different sizes; more lesions in both upper lobes and the right middle lobe; flaky parenchyma shadows in the apical and posterior segments of right upper lobe, with air bronchogram sign in them; unobstructed opening of bronchi as well as lobar and segmental bronchi without stenosis and obstruction; lymphadenectasis in the right hilar region; detected Aspergillus fumigatus by sputum culture. (e, f) Culture for 72 h, lactic acid gossypol blue staining and microscopic observation at ×200 and ×400 demonstrate short column liked conidial head, smooth wall of conidiophores, flask-shaped top capsule and monolayer microconidiophores. (g) Culture in Paul’s medium demonstrates dark green colored colonies', 'hash': 'af925cb00cbd4eed9e67dc49fd012909ecdfe48493ac645d8b2185eb4f351655'}, {'image_id': '313891_1_En_17_Fig105a_HTML', 'image_file_name': '313891_1_En_17_Fig105a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig105a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary toxoplasmosis. (a–d) CT scanning demonstrates thickened pulmonary markings in both lungs, which can be enhanced to extend into the middle and outer zones of lungs, in grid liked appearance that is more obvious in the dorsal segment of the lungs. (e) It is demonstrated to have clustering toxoplasma tachyzoites', 'hash': '30f16a35256e45c89dfcd68adf661507960a5b978db88cc531a7605d9fff53df'}, {'image_id': '313891_1_En_17_Fig95_HTML', 'image_file_name': '313891_1_En_17_Fig95_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig95_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a) CT scanning of the pulmonary window demonstrates irregular large flaky shadows with increased density in the dorsal segment of both lower lobes; enlarged hilum in both lungs, cords liked thickening of the vascular vessels. (b) CT scanning of the mediastinal window demonstrates flaky parenchyma shadows in the left lower lung, thickening of both pleura, enlarged hilum shadows in both lungs, thickened right lower bronchial wall. (c) Microscopy after culture at 25 °C demonstrates branches and separated hyphae and its string of small spores, with typical penicillus but no sporangium (Medan staining, ×400). (d) Bone marrow smear demonstrates round or oval cells like the yeast phase within the macrophages; longer cells like the yeast phase outside the macrophages. The two kinds of cells have slightly curved ends in sausages liked appearance (HE staining, ×400)', 'hash': '636de07e02ba7cf1f73f2a03bccf4fdaac68bc4a122b7fbfe2febe72dd42f139'}, {'image_id': '313891_1_En_17_Fig3a_HTML', 'image_file_name': '313891_1_En_17_Fig3a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig3a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy and scattered miliary increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of the lower lung field, with some fused in thin cloudy shadows', 'hash': 'e655c40874d38beaa8a8e9f0e82c1eb12a6756b09bee559229354b3756010a18'}, {'image_id': '313891_1_En_17_Fig73_HTML', 'image_file_name': '313891_1_En_17_Fig73_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig73_HTML.jpg', 'caption': '(a–c) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates diffuse dense shadows in both lower lung fields which is in a arcuate surface with exterior high and interior low (pleural effusion). (b, c) CT scanning of the mediastinal window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavities; thickened pleura of the lateral chest wall, with accompanying encapsulated effusion', 'hash': '9ad36ea5213bea731770658b27be87e1af9e34bced02cda664a7f485e40f2315'}, {'image_id': '313891_1_En_17_Fig54_HTML', 'image_file_name': '313891_1_En_17_Fig54_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig54_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates round liked large flaky shadows with increased density in the left lower lung, enlarged and thickened hilus. (c, d) DR reexamination after treatment demonstrates flocculent shadows in the left lower lung, with improved conditions than previous findings before treatment (a, b)', 'hash': 'f9b4f22920ef55d9110380df6f64a6a508ecea9ca3192877a2d47400e781c58d'}, {'image_id': '313891_1_En_17_Fig58b_HTML', 'image_file_name': '313891_1_En_17_Fig58b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig58b_HTML.jpg', 'caption': '(a–i) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) CT scanning of the pulmonary window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (c, d) CT scanning of the mediastinal window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, pulmonary atelectasis and pleural effusion, with ventilation shadows in them. (e) CT scanning of the pulmonary window after the treatment demonstrates absence of the mass shadows in the left lower lung with transverse stripes shadows, obviously improved than previous findings (a, b). (f) HE staining demonstrates thickened alveolar septa and exudates from the alveolar cavity. (g) HE staining demonstrates massive bleeding in the alveolar cavity, large quantity erythrocytes and intact cell walls. (h) HE staining demonstrates phagocytized basophilic granules in the leukocytes. (i) HP staining demonstrates purplish red Rhodococcus equi in a shape of crescent in orange red sputum', 'hash': 'ca8456a79f660fc4faa5eb9342f84a14bbe25eedd8fb237ac65bd96b8de6e5b9'}, {'image_id': '313891_1_En_17_Fig25c_HTML', 'image_file_name': '313891_1_En_17_Fig25c_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25c_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '64e0ceda545f1684d11c717eef852c6576036d711540954850cc018aadfefa87'}, {'image_id': '313891_1_En_17_Fig44_HTML', 'image_file_name': '313891_1_En_17_Fig44_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig44_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary nontuberculous mycobacterial infection. (a–d) CT scanning demonstrates multiple cavities in the left lung field, bilateral multiple lobular central nodules and extensive branches liked linear shadows in tree buds sign. There are also large flaky parenchymal changes of the lung tissues in the left lower lung field in high density shadows, with accompanying air bronchogram sign. (e) HE staining demonstrates avium intracellular complex mycobacteria infection of lung tissues in atypical tuberculous nodular changes. (HE\u2009×\u2009200)', 'hash': '8f8697761c60c3cb27c0b413c2e19433df26ba07a74ea0a0cc0b6f2b4acc7b65'}, {'image_id': '313891_1_En_17_Fig103_HTML', 'image_file_name': '313891_1_En_17_Fig103_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig103_HTML.jpg', 'caption': '(a–d) HIV/AIDS related lymphoid interstitial pneumonia. (a–d) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs, in reticular appearance; with accompanying multiple small nodular shadows', 'hash': '8d52c3bac6fb07e3eaf12386767e159f762db3072e09365be542c937697babe7'}, {'image_id': '313891_1_En_17_Fig110b_HTML', 'image_file_name': '313891_1_En_17_Fig110b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110b_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '5526a48dae3face516d842ba229b164bac3062f56c5e811bb1e725778fd20823'}, {'image_id': '313891_1_En_17_Fig5a_HTML', 'image_file_name': '313891_1_En_17_Fig5a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig5a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates patchy shadows with increased density in both lungs, with thickened hilar shadows in both lungs. (b–g) CT scanning demonstrates flaky ground glass liked density shadows in upper lungs and dorsal segment of both lungs, which is more obvious in the middle inner strips. There are extrapulmonary stripes transparent shadows, with some bronchial walls thickened and enlarged hilar shadows in both lungs', 'hash': '5d6ab0400e0331b0fcb3a3679023a44fa81b7b9c9eedc00c0ddb6d85208c3512'}, {'image_id': '313891_1_En_17_Fig74_HTML', 'image_file_name': '313891_1_En_17_Fig74_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig74_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates round liked uneven density shadows in the medial segments of both middle and lower lungs, multilocular hollow holes in the cavities, surrounding multiple round liked thick-wall small cavity shadows and ground grass liked infiltration shadows. (b–d) CT scanning of the pulmonary window demonstrates scattered round liked uneven density shadows in the right hilum and lower lung, multilocular hollow holes in the cavities; and surrounding multiple round liked thick-wall small cavity shadows and ground grass liked infiltration shadows', 'hash': 'e4c42cc0cb1f1bdfa8b2cc1f3c8eab7223c4be368a808e8b6c4b01af78dfb04a'}, {'image_id': '313891_1_En_17_Fig23_HTML', 'image_file_name': '313891_1_En_17_Fig23_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig23_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymph node tuberculosis. (a–c) CT scanning of the pulmonary window demonstrates dense mass shadow beside the right aortic arch, and thinner right bronchus due to compression. (d–f) CT scanning of the mediastinal window demonstrates low density mass shadow besied the right aortic arch with clear boundary', 'hash': '8d135ce7e96005006343dc3305be0f8c77d0828bccccf1726226c09fd47c365f'}, {'image_id': '313891_1_En_17_Fig6a_HTML', 'image_file_name': '313891_1_En_17_Fig6a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig6a_HTML.jpg', 'caption': '(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe', 'hash': '235548456c9bf72727a05a91fa6893d8a478f8f715c022d6b579d4a9188da366'}, {'image_id': '313891_1_En_17_Fig17a_HTML', 'image_file_name': '313891_1_En_17_Fig17a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig17a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchymal shadows and fibrous cords liked shadows in both lungs which are more obvious in both lower lungs. The trachea and bronchi are unblocked, with enlarged hilar shadows in both lungs', 'hash': '9c1c59095291dcf6a7b6dec786ec58ba44e9b83badfe4bbf121b7c677476f4d5'}, {'image_id': '313891_1_En_17_Fig113b_HTML', 'image_file_name': '313891_1_En_17_Fig113b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig113b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Kaposi’s sarcoma. (a–d) Chest CT scanning demonstrates scattered cloudy, mass and flake liked or nodular shadows with increased density. (e) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large thick stained nucleoli, which are in line with the diagnosis of Kaposi’s sarcoma. (f–i) Cured HIV/AIDS related Kaposi’s sarcoma. (f–i) Reexamination after treatment demonstrates absent lesions in both lungs, with clear lung fields', 'hash': '88e574b2d5ff4ee4ce28f38025d5345c8cf6b50386f752ae12083b05fe7af9de'}, {'image_id': '313891_1_En_17_Fig82_HTML', 'image_file_name': '313891_1_En_17_Fig82_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig82_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a, b) DR demonstrates enlarged blurry hilum in both lungs and thickened pulmonary markings. (c, d) CT scanning demonstrates mediastinal lymphadenectasis, narrowed trachea due to compression with liquefactive necrosis. Enhanced scanning demonstrates marginal enhancement and no central enhancement', 'hash': '18312183daaefbc6c48e05e67fab210a1109c24a6f94311ffb11ffdace007a49'}, {'image_id': '313891_1_En_17_Fig64_HTML', 'image_file_name': '313891_1_En_17_Fig64_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig64_HTML.jpg', 'caption': '(a) Gross observation demonstrates dark brown lungs in appearance. (b, c) Thology demonstrates hemorrhage and edema of the lung tissue and focal necrosis, with large quantity Aspergillus hyphae and spores in the surrounding area of the necrosis (Combined with pulmonary CMV infection)', 'hash': '104850f2999da711317f4e4f07e590bd8f73a93731daf090ece6023192606e90'}, {'image_id': '313891_1_En_17_Fig7a_HTML', 'image_file_name': '313891_1_En_17_Fig7a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig7a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates diffusely distributed shadows with increased density in both lungs that is more obvious in the middle and lower lungs. The hilar shadows in both lungs are enlarged. Both diaphragmatic surfaces and phrenic angles are blurry. (b–d) CT scanning demonstrates flaky shadows with increased density in both lungs, with parenchymal shadows in the lingular segment of left upper lobe and in the dorsal segments of both lower lobes and bronchial shadows in them. There are also thickened bronchial walls and enlarged hilar shadows in both lungs', 'hash': '431aab0770a1915c719095cc2bab91736f1ffda7b5649cdca5d8b7516003049c'}, {'image_id': '313891_1_En_17_Fig33_HTML', 'image_file_name': '313891_1_En_17_Fig33_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig33_HTML.jpg', 'caption': '(a, b) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates scattering patchy and cords liked blurry density shadows in the right middle and upper lung fields as well as enlarged and thickened hilum. (b) DR demonstrates that the lungs lesions are almost absent compared to (a), after anti-TB treatment for 5 months', 'hash': 'e710598bbbc8286721136f2a803716198a712c55253c4232d3ee33b2e33e188b'}, {'image_id': '313891_1_En_17_Fig62_HTML', 'image_file_name': '313891_1_En_17_Fig62_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig62_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) Anteroposterior and lateral DR demonstrates huge sphere liked mass shadow in the right hilum, with cavities shadows and liquid gas level in it. (c) HE staining demonstrates bleeding in the lung tissues and aggregation of large quantity lymphocytes. (d) Masson staining demonstrates branches liked purplish red Rhodococcus equi', 'hash': '261a4aca9e146cc16957c6280cd4795d7c2c5732d9a19006b6e398a1ae410af0'}, {'image_id': '313891_1_En_17_Fig84_HTML', 'image_file_name': '313891_1_En_17_Fig84_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig84_HTML.jpg', 'caption': '(a, b) HIV/AIDS related pulmonary cryptococcus infection. (a) CT scanning demonstrates round liked cavity shadows in the left upper and lower lung, with uneven thickness of the cavity wall and surrounding infiltrative shadows. (b) CT scanning demonstrates round liked dense mass shadows in the right upper lung, with clear boundaries and bulky drainage vessel shadows', 'hash': 'ecc614167ec536dcb80c2739886c957ff2f182dd49ac7f4d6379260497262e60'}, {'image_id': '313891_1_En_17_Fig4_HTML', 'image_file_name': '313891_1_En_17_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig4_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy or ground glass liked increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of lower lungs, with some fused into thin cloudy ground glass liked shadows with increased density, with decreased transparency of both lungs and enlarged hilar shadows in both lungs', 'hash': '636f9fd3d3c20c17e15e1ac70adcdcb6fbe268a70ac64d29317f73045747e226'}, {'image_id': '313891_1_En_17_Fig46a_HTML', 'image_file_name': '313891_1_En_17_Fig46a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig46a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates large flaky dense shadows in the middle-outer zone of the left middle lung field, and narrowed left bronchus. (d–f) CT scanning demonstrates large flaky shadows with uneven density in the left lateral chest wall and even lower density shadow in them', 'hash': 'afdfc2c33070f1d3b8616a542d989e0f908d9638327227057dfdf5ed59169359'}, {'image_id': '313891_1_En_17_Fig72_HTML', 'image_file_name': '313891_1_En_17_Fig72_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig72_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and cavity shadows in both lungs, with even wall thickness and small nodular shadows in some cavities', 'hash': 'd318b47b9b56854b6bc47081b08712ee9d828a2ae4592aa69451ec7105fd0240'}, {'image_id': '313891_1_En_17_Fig91b_HTML', 'image_file_name': '313891_1_En_17_Fig91b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig91b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–e) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of some lesions into honeycomb likes cavity shadows or plaque liked dense shadows. (f–h) CT scanning demonstrates large thick-wall cavity shadows in the right lung, surrounding plaque and round liked small cavity shadows and inflammatory infiltrative shadows', 'hash': '6b3a934b89abf6f7e8c9593337c0c57fe44161bcbfc546c7e2a3cfa50539f91e'}, {'image_id': '313891_1_En_17_Fig8a_HTML', 'image_file_name': '313891_1_En_17_Fig8a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig8a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates large flaky parenchyma shadows in both lungs which is more obvious in the middle and lower lobes of both lungs. There are also enlarged hilar shadows in both lungs and sharp both costophrenic angles. (b–g) CT scanning demonstrates large flaky parenchyma shadows in concentric and symmetrical distribution, bronchial shadows in them and thickened bronchial walls', 'hash': '7c4f2f4f9120af70727cab6fc69637733e17e807575648a0257b5b03367da625'}, {'image_id': '313891_1_En_17_Fig42_HTML', 'image_file_name': '313891_1_En_17_Fig42_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig42_HTML.jpg', 'caption': 'HIV/AIDS related tuberculous pleuritis. DR demonstrates arch shaped dense shadows with higher exterior density and lower interior density in the left lower lung field and covered right edge of the heart', 'hash': 'f0dfdb1b349a42c7092daeeaef76a8b8762e134b40ae21a6144d9785b9ddcd02'}, {'image_id': '313891_1_En_17_Fig15_HTML', 'image_file_name': '313891_1_En_17_Fig15_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig15_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy blurry shadows and fibrous cords liked shadows in both lungs which are more obvious in the middle inner parts of both lungs, with transparent areas in them. The bronchial walls are thickened', 'hash': '4d262b5c06f74783c1b6df1f8c9d8c7ecbf235faacd2f2e846544a3e11d88e8b'}, {'image_id': '313891_1_En_17_Fig92b_HTML', 'image_file_name': '313891_1_En_17_Fig92b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig92b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs', 'hash': '4613e0bd8bbb013024b2335ae2f7fb1997dab5d93ee1c395c97035d6e7d37750'}, {'image_id': '313891_1_En_17_Fig52_HTML', 'image_file_name': '313891_1_En_17_Fig52_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig52_HTML.jpg', 'caption': '(a, b) HIV/AIDS related staphylococcus aureus pneumonia. (a, b) DR demonstrates diffuse scattered multiple thin-walled transparent areas in both lungs, increased and blurry pulmonary markings, and enlarged heart shadow in flask shape (pericardial effusion)', 'hash': 'b54d395f8405b646839c68cb58c1a811c70fb8c7337443d24b61bfcfa097f5b0'}, {'image_id': '313891_1_En_17_Fig56b_HTML', 'image_file_name': '313891_1_En_17_Fig56b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig56b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates huge round large flaky shadows with increased density in the left lower lung, enlarged and thickened hilum and covered right heart edge. (c, d) DR reexamination after treatment for 1 week demonstrates flocculent shadow in the left lower lung, improved than those before the treatment (a, b). (e) DR reexamination after treatment demonstrates flocculent liked shadows in the left lower lung, obviously improved than before the treatment (c, d)', 'hash': 'e5f534ed9282980e95aaa6bac04091762128cf3e5c46985b190278c5d6396558'}, {'image_id': '313891_1_En_17_Fig93b_HTML', 'image_file_name': '313891_1_En_17_Fig93b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig93b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates diffuse small cavity in honeycomb liked and infiltrative parenchyma shadows, with the hilum as the center to distribute bilaterally symmetric like butterfly wings; multiple honeycomb liked cavity shadows in both lungs. (e–h) CT scanning reexamination demonstrates large irregular thick-wall cavities in the right lung, surrounding scattering nodular, honeycomba liked and infiltrative shadows after anti-PM infection treatment for 3 months', 'hash': '904e5a590c601ab02150f8c2487bbfa6f0282c1eddd547624ce8c549472221d9'}, {'image_id': '313891_1_En_17_Fig51b_HTML', 'image_file_name': '313891_1_En_17_Fig51b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig51b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related staphylococcus aureus pneumonia. (a) Chest X-ray demonstrates large flaky high density shadow in the left middle-lower lung field, with central transparent areas in different sizes and blurry boundaries; parenchyma changes of the left lower lung, predominantly in the posterior and exterior basal segments; unobstructed brounchus and thickened adjacent pleura. (b–d) CT scanning demonstrates large flaky shadows in fan shaped distribution along the bronchus in the left middle-lower lung, with gas containing cavities and high density shadows; and thickened adjacent pleura of the lateral chest wall. (e, f) CT scanning of the mediastinal window demonstrates large flaky fan shaped parenchymal shadows in the left middle-lower lung field, with ventilation shadows in them; and thickened pleura of the lateral chest wall. (g, h) Pathological examination showed staphylococcus aureus', 'hash': '18a6e1202b7b8c4a2d57fe024b7e8039a6dcee0f6f5f078b109a93850977c0f6'}, {'image_id': '313891_1_En_17_Fig94b_HTML', 'image_file_name': '313891_1_En_17_Fig94b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig94b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a–f) CT scanning demonstrates multiple nodules and small cavities in honeycomb liked shadows and infiltrative parenchyma shadows in the right lung; flaky transparent areas (bullae of lung) in the right anterior margin of the heart and in the outer zone of the left lung near lateral chest wall', 'hash': '3ed719abaaaec4ee19332842bd8dcac302eb6fefc73152dfd03a39702260d369'}, {'image_id': '313891_1_En_17_Fig34a_HTML', 'image_file_name': '313891_1_En_17_Fig34a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig34a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung and multiple satellite lesions scattering around. (c) CT scanning of the mediastinal window demonstrates lymphadenectasis of aortic window, subcutaneous soft tissue mass shadow in the left anterior chest wall with central low density shadow as well as right axilliary lymphadenectasis', 'hash': 'dabd5722ad3f66eee67ca59ba24417ffb086d4591f3bff2446f2a3490c676e78'}, {'image_id': '313891_1_En_17_Fig22_HTML', 'image_file_name': '313891_1_En_17_Fig22_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig22_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates semicircular mass liked dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura of lateral chest wall, and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates narrowed right thorax, thickend pleura of lateral chest wall with encapsulated effusion, uneven density mass in the right hilum, thinner right bronchus due to compression and no obvious abnormalities in the left hilum. (f) DR in Aug. 2008 demonstrates no obvious changes of the lesions after anti-tuberculosis treatment for 1 month', 'hash': '8f3d47e32ff0f306eed49c4101730b02a154f676752c7bb56423c767388d5b82'}, {'image_id': '313891_1_En_17_Fig27b_HTML', 'image_file_name': '313891_1_En_17_Fig27b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig27b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related miliary tuberculosis. (a–b) Anteroposterior and lateral DR demonstrates diffuse miliary shadows in both lungs, which are bilaterally symmetric and in even size and distribution. (c–f) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': 'e272956e522e945d068939f056c637c5a636df520c687deeac9d40f8cb06834e'}, {'image_id': '313891_1_En_17_Fig83_HTML', 'image_file_name': '313891_1_En_17_Fig83_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig83_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates enlarged blurry hilum in both lungs and thickened lung markings. (b–d) CT scanning demonstrates multiple scattered nodular or mass dense shadows in both lungs, with lobulation, rough spikes around and fusion of some shadows into mass; surrounding small flaky infiltrative shadows; and mediastinal lymphadenectasis', 'hash': '6b17ec5d2db4d953c2436bbec29d0a3b1dacf0910df899eaf97e442c4aaad785'}, {'image_id': '313891_1_En_17_Fig43a_HTML', 'image_file_name': '313891_1_En_17_Fig43a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig43a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related tuberculous pleuritis. (a) DR demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (b) CT scanning of the pulmonary window demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (c) CT scanning of the mediastinal window demonstrates encapsulated fluid density shadow in the pleura of the right lateral chest wall', 'hash': 'ac09c8d3e5e4d73b07cd258411b07337ad06b99883f4a0e4573ce220fc1f4574'}, {'image_id': '313891_1_En_17_Fig35a_HTML', 'image_file_name': '313891_1_En_17_Fig35a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig35a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates diffuse large flaky dense shadows in the right upper lung with transparent areas in them. (b–c) CT scanning of the pulmonary window demonstrates large flaky shadows with increased density in the right upper lung, with multiple satellite lesions scattering around. (d, e) CT scanning of the mediastinal window demonstrates large flaky parenchymal shadows in the right upper lung with air bronchogram sign as well as mediastinal lymphadenectasis', 'hash': 'f556b77354da8136691c411ed446865babea0e399d96d2fca89f49639a04c579'}, {'image_id': '313891_1_En_17_Fig26b_HTML', 'image_file_name': '313891_1_En_17_Fig26b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig26b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '1d1f0589c50a11306fce77c217b0a9ac31be645df14f41d021ccf6522873dc6c'}, {'image_id': '313891_1_En_17_Fig32_HTML', 'image_file_name': '313891_1_En_17_Fig32_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig32_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstratesdiffuse scattering miliary shadows with increased density in both lungs, fusion of some military shadows into patchy or mass liked shadows and diffusely distributed lung lesions', 'hash': '7274d90d4f9483c5fb0e44576eeb46beba54850ed218057b6ca5935c31fa396a'}, {'image_id': '313891_1_En_17_Fig96b_HTML', 'image_file_name': '313891_1_En_17_Fig96b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig96b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a) DR demonstrates flaky blurry dense shadows in the right anterior margin of the heart, with surrounding infiltrative shadows. (b, c) CT scanning of the pulmonary window demonstrates nodular dense shadows in the dorsal segment of the right lower lung, with smooth sharp boundaries; large flaky ground glass liked dense shadows in the dorsal segment of both lungs. (d, e) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in red, in different sizes. (f) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in purplish red, in different sizes', 'hash': 'ad87dabd309e8a0c47d5cd58aa485a538556b1218d18c3cb262dc5b8cd5049e9'}, {'image_id': '313891_1_En_17_Fig55_HTML', 'image_file_name': '313891_1_En_17_Fig55_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig55_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates round liked large flaky shadows with increased density in the right lower lung, cords liked and flocculent liked blurry shadows in both middle-upper lung fields and in the right lower lung field, and enlarged and thickened hilus', 'hash': '29c690f04a28629d1c3b0f7b5665833edd78ec61be199fd2f16199400a7c9eeb'}, {'image_id': '313891_1_En_17_Fig85a_HTML', 'image_file_name': '313891_1_En_17_Fig85a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig85a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates round liked thick-wall cavity in the left hilum, with blurred boundary; ground-glass liked shadows with increased density in the left middle and lower lung. (b–d) CT scanning of the pulmonary window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of cavity wall. (e, f) CT scanning of the mediastinal window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of the cavity wall and surrounding thick spikes', 'hash': 'd6bc5b1be05729f5f4ec60a0cda3bec7f7cf437fd39e0d32743e45cfb9e48de2'}, {'image_id': '313891_1_En_17_Fig112_HTML', 'image_file_name': '313891_1_En_17_Fig112_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig112_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Kaposi’s sarcoma. (a, b) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance', 'hash': 'eeb255e4963802d02da7fd85381532153336be33b21e4ceb488be5dc2a483f29'}, {'image_id': '313891_1_En_17_Fig25b_HTML', 'image_file_name': '313891_1_En_17_Fig25b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25b_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '9ceac8f407a9896d7bda0165bceae81a32d5c5c53de3c5d2a295c165b15071e8'}, {'image_id': '313891_1_En_17_Fig36a_HTML', 'image_file_name': '313891_1_En_17_Fig36a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig36a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) Pulmonary CT scanning of the pulmonary window demonstrates parenchymal shadows in the left lingual lobe with surrounding pulmonary acinar nodular shadows. (b) CT guided pucture biopsy of left lingula. (c) The pathology demonstrates granulation tissue and caseous necrosis, being in consistency with tuberculosis changes. HE\u2009×\u2009100', 'hash': '3a48cc084a1fb1943e1411fa65cfdcee0c3c33377b3ae6ab6e24f04ee1caebae'}, {'image_id': '313891_1_En_17_Fig68a_HTML', 'image_file_name': '313891_1_En_17_Fig68a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig68a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in prone posture demonstrates mass shadow and thick wall cavity in the dorsal segment of the right lower lung, small nodular shadows in the cavities, surrounding fused miliary infiltration shadows. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the dorsal segment of the right lower lung, small nodular shadows in the cavities, and involved pleura of partial lateral chest wall', 'hash': '0acc77833f25b70e7e4527a30be9fc6744e19cee48879415a15e648d76923d48'}, {'image_id': '313891_1_En_17_Fig45_HTML', 'image_file_name': '313891_1_En_17_Fig45_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig45_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Staphylococcus aureus pneumonia. (a) Gross specimen observation demonstrates bilateral purplish brown lesions, patchy white infiltration at the base of the lungs. (b) HE staining demonstrates alveolar diffuse lesions, exudation of the serous fluid and inflammatory cells in the alveolar cavity, and alveolar wall congestion', 'hash': 'e530a1df1ead29989d8b3b50161f1926946446bc5cbbcb99691479816876e341'}, {'image_id': '313891_1_En_17_Fig110c_HTML', 'image_file_name': '313891_1_En_17_Fig110c_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110c_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '22d9f8a4fa731c46a738334c9738c267aaa2c43711aa94bd98c4b78483adda8d'}, {'image_id': '313891_1_En_17_Fig24b_HTML', 'image_file_name': '313891_1_En_17_Fig24b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig24b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates circular mass dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura in the lateral chest cavity and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates multiple uneven mass density shadows in right hilum in a size of about 3\u2009×\u20093.5\u2009×\u20093.8 cm. (f–g) Enhanced CT scanning demonstrates slight uneven enhancement of the lesion and no obvious abnormalties in the left hilum', 'hash': '4c7c3a8f7b0bde1c89efcf634beedfd08159b9be03a95299448e388c435edcdc'}, {'image_id': '313891_1_En_17_Fig12_HTML', 'image_file_name': '313891_1_En_17_Fig12_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig12_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchyma shadows and fibrous cords liked shadows in both lungs which are more obvious in the dorsal segment of both lower lungs, bronchial shadows in them, and thickened bronchial walls in the middle lobe. The hilar shadows in both lungs are enlarged', 'hash': '72a066b603a93a4b8e9a7a8ec1942b2ed87b211dee6ed121b7c56d1cb575c55c'}, {'image_id': '313891_1_En_17_Fig102_HTML', 'image_file_name': '313891_1_En_17_Fig102_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig102_HTML.jpg', 'caption': '(a–d) HIV/AIDS related lymphoid interstitial pneumonia. (a–d) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs, in reticular appearance; with accompanying multiple small nodular shadows', 'hash': '6b569d4d7a5a4f008ea8f7bc4152cd1a576656b8eeee8b7548f00de038815256'}, {'image_id': '313891_1_En_17_Fig111_HTML', 'image_file_name': '313891_1_En_17_Fig111_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig111_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Kaposi’s sarcoma. (a, b) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance, light density flaky shadows in lower lung fields of both lungs. (c) CT scanning demonstrates multiple round liked nodular shadows in both middle lower lung fields with clear boundaries, multiple mediastinal and hilar lymphadenectasis, and small quantity pleural effusion in bilateral thoracic cavities', 'hash': '5dfb9d581ecc41659920bde84bc55d01903bf9f66ec50710fe0465373096ff5f'}, {'image_id': '313891_1_En_17_Fig25a_HTML', 'image_file_name': '313891_1_En_17_Fig25a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25a_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '67db71f0f56d65c929e36f486b4a1a2246ae852aec999328f126ddc09428f814'}, {'image_id': '313891_1_En_17_Fig36b_HTML', 'image_file_name': '313891_1_En_17_Fig36b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig36b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) Pulmonary CT scanning of the pulmonary window demonstrates parenchymal shadows in the left lingual lobe with surrounding pulmonary acinar nodular shadows. (b) CT guided pucture biopsy of left lingula. (c) The pathology demonstrates granulation tissue and caseous necrosis, being in consistency with tuberculosis changes. HE\u2009×\u2009100', 'hash': 'd7d5abe0c9d9bea2e2097dfc72f86922656058f98f8a2360573b04a02e27e5de'}, {'image_id': '313891_1_En_17_Fig68b_HTML', 'image_file_name': '313891_1_En_17_Fig68b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig68b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in prone posture demonstrates mass shadow and thick wall cavity in the dorsal segment of the right lower lung, small nodular shadows in the cavities, surrounding fused miliary infiltration shadows. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the dorsal segment of the right lower lung, small nodular shadows in the cavities, and involved pleura of partial lateral chest wall', 'hash': 'cada0e4684021c74f9b0d4d1bcdb6810379bc035cead748d6de141ebd004f038'}, {'image_id': '313891_1_En_17_Fig96a_HTML', 'image_file_name': '313891_1_En_17_Fig96a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig96a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a) DR demonstrates flaky blurry dense shadows in the right anterior margin of the heart, with surrounding infiltrative shadows. (b, c) CT scanning of the pulmonary window demonstrates nodular dense shadows in the dorsal segment of the right lower lung, with smooth sharp boundaries; large flaky ground glass liked dense shadows in the dorsal segment of both lungs. (d, e) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in red, in different sizes. (f) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in purplish red, in different sizes', 'hash': '020553d48c8545e50d314020ad8dc5004914dca5449aa2b58bc99515f310c3a4'}, {'image_id': '313891_1_En_17_Fig85b_HTML', 'image_file_name': '313891_1_En_17_Fig85b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig85b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates round liked thick-wall cavity in the left hilum, with blurred boundary; ground-glass liked shadows with increased density in the left middle and lower lung. (b–d) CT scanning of the pulmonary window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of cavity wall. (e, f) CT scanning of the mediastinal window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of the cavity wall and surrounding thick spikes', 'hash': '9778eb0d00755e3cd06bd3bcee90d66970730aac4b7fabde0b3e1df25cc067b8'}, {'image_id': '313891_1_En_17_Fig59_HTML', 'image_file_name': '313891_1_En_17_Fig59_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig59_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a–c) CT scanning of the pulmonary window demonstrates thick walled cavities shadows in the dorsal segment of the right lower lung, with irregular wall thickness and liquid gas level in them. (d) CT scanning of the mediastinal window demonstrates thick walled cavities shadows in the dorsal segment of the left lower lung, with irregular wall thickness and liquid gas level in them', 'hash': 'c9ff1150b9c2d245c823a3726a56dc22223fcdc58b24666ee55ee0b01ea0c2d3'}, {'image_id': '313891_1_En_17_Fig24a_HTML', 'image_file_name': '313891_1_En_17_Fig24a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig24a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates circular mass dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura in the lateral chest cavity and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates multiple uneven mass density shadows in right hilum in a size of about 3\u2009×\u20093.5\u2009×\u20093.8 cm. (f–g) Enhanced CT scanning demonstrates slight uneven enhancement of the lesion and no obvious abnormalties in the left hilum', 'hash': 'a3536c779e7c502b855dd3d89ae13854f569bd483ba8038870ac76c68c616c6c'}, {'image_id': '313891_1_En_17_Fig11_HTML', 'image_file_name': '313891_1_En_17_Fig11_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig11_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered patchy shadows with increased density in both lungs and a few cords liked shadows which are more obvious in the right lung. There are thickened both hilar shadows and sharp both costophrenic angles. (b–e) CT scanning demonstrates flaky and mass liked ground glass density shadows in both lungs and a few cords liked shadows which are more obvious in the right lung. The trachea and bronchi are unblocked', 'hash': 'd4448bd9682d4ae721b1250cec042eecf77787519b1af61ac3b2d7b88b28bd90'}, {'image_id': '313891_1_En_17_Fig101_HTML', 'image_file_name': '313891_1_En_17_Fig101_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig101_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Herpes Simplex Viral Pneumonia. (a) DR demonstrates thickened and deranged lung markings in both lungs with accompanying blurry nodular shadows, and cloudy shadows in the lung fields. (b) PAS staining (400×) demonstrates eosinophilic inclusion. (c) Silver methenamine staining demonstrates herpes viral inclusion', 'hash': '9cfda956483a95dc3a4e487426e884d83e6aa0bde654b2c285ba044cf31b2a1d'}, {'image_id': '313891_1_En_17_Fig49_HTML', 'image_file_name': '313891_1_En_17_Fig49_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig49_HTML.jpg', 'caption': '(a–d) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates fan shaped shadow in the right middle lung field with its apex pointing to the hilar dense shadow, with clear boundaries. (d) CT scanning reexamination demonstrates absence of the lesions in the right lung after anti-bacteria treatment for 2 weeks', 'hash': 'f566a271be67724833f92b19b4f73190cae4216ad698f1d1a51c1d9c7579afa1'}, {'image_id': '313891_1_En_17_Fig34b_HTML', 'image_file_name': '313891_1_En_17_Fig34b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig34b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung and multiple satellite lesions scattering around. (c) CT scanning of the mediastinal window demonstrates lymphadenectasis of aortic window, subcutaneous soft tissue mass shadow in the left anterior chest wall with central low density shadow as well as right axilliary lymphadenectasis', 'hash': 'cd2bbefb6363363a2c860069ded9e79b5fabed794f0777f342cd459e7f745581'}, {'image_id': '313891_1_En_17_Fig21_HTML', 'image_file_name': '313891_1_En_17_Fig21_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig21_HTML.jpg', 'caption': '(a–c) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates enlarged right hilum in mass liked dense shadow, with peripheral thickened and blurry pulmonary markings, and no obvious abnormalities of the left hilum. (b) DR demonstrates smaller right hilum after anti-tuberculosis therapy for 1 month. (c) DR demonstrates absent tumor in the right hilum and normal left hilum', 'hash': '46a1a9267e1d610faa6450929c11c8d942047467baf49ba4482ce61bb660cb30'}, {'image_id': '313891_1_En_17_Fig27a_HTML', 'image_file_name': '313891_1_En_17_Fig27a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig27a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related miliary tuberculosis. (a–b) Anteroposterior and lateral DR demonstrates diffuse miliary shadows in both lungs, which are bilaterally symmetric and in even size and distribution. (c–f) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '61497bd4be4942d8a1fc4e6710043c9d4099da58ea99f2008d49f04ec973f2b4'}, {'image_id': '313891_1_En_17_Fig79_HTML', 'image_file_name': '313891_1_En_17_Fig79_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig79_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates multiple scattered nodular shadows in both lower lungs. (b–d) Chest CT scanning demonstrates multiple dense nodular shadows with different sizes and mass shadows in both middle and lower lung fields, with clear boundaries. They are more common in the dorsal segments', 'hash': '7f1588a4af3d4fadaf1f33e3bac3f100d4b2003206bd1bc2ae262b602fd3fe79'}, {'image_id': '313891_1_En_17_Fig51a_HTML', 'image_file_name': '313891_1_En_17_Fig51a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig51a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related staphylococcus aureus pneumonia. (a) Chest X-ray demonstrates large flaky high density shadow in the left middle-lower lung field, with central transparent areas in different sizes and blurry boundaries; parenchyma changes of the left lower lung, predominantly in the posterior and exterior basal segments; unobstructed brounchus and thickened adjacent pleura. (b–d) CT scanning demonstrates large flaky shadows in fan shaped distribution along the bronchus in the left middle-lower lung, with gas containing cavities and high density shadows; and thickened adjacent pleura of the lateral chest wall. (e, f) CT scanning of the mediastinal window demonstrates large flaky fan shaped parenchymal shadows in the left middle-lower lung field, with ventilation shadows in them; and thickened pleura of the lateral chest wall. (g, h) Pathological examination showed staphylococcus aureus', 'hash': '00d7fc70edd23ceb6f012159d4bae8563ec20a036cc91fd99d91cdbc08f23126'}, {'image_id': '313891_1_En_17_Fig90_HTML', 'image_file_name': '313891_1_En_17_Fig90_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig90_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows in the lungs that fuse into mass in parenchymal shadows, with the hilum as the center and distributing bilaterally symmetric like butterfly wings. There are also multiple clustering cavities or singular large cavity in both lungs', 'hash': '6742eff5e10355ff74a6fe215cff47247a9d12856c453a35fd6d6742f8f0ac2e'}, {'image_id': '313891_1_En_17_Fig94a_HTML', 'image_file_name': '313891_1_En_17_Fig94a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig94a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a–f) CT scanning demonstrates multiple nodules and small cavities in honeycomb liked shadows and infiltrative parenchyma shadows in the right lung; flaky transparent areas (bullae of lung) in the right anterior margin of the heart and in the outer zone of the left lung near lateral chest wall', 'hash': '4bf177cdb556a837613a60231e962930fcd4acf34d7177f738cb57925ca917e1'}, {'image_id': '313891_1_En_17_Fig35b_HTML', 'image_file_name': '313891_1_En_17_Fig35b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig35b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates diffuse large flaky dense shadows in the right upper lung with transparent areas in them. (b–c) CT scanning of the pulmonary window demonstrates large flaky shadows with increased density in the right upper lung, with multiple satellite lesions scattering around. (d, e) CT scanning of the mediastinal window demonstrates large flaky parenchymal shadows in the right upper lung with air bronchogram sign as well as mediastinal lymphadenectasis', 'hash': '8b68f2c89884110f18b2b9641154ae26362875fb18db9a64b4320edd5c13bba4'}, {'image_id': '313891_1_En_17_Fig26a_HTML', 'image_file_name': '313891_1_En_17_Fig26a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig26a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '1bd3c2b9622fa99531543c1b9d456f58ff2945c6fa4bb44043fadb51fa9c8db6'}, {'image_id': '313891_1_En_17_Fig31_HTML', 'image_file_name': '313891_1_En_17_Fig31_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig31_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, fusion of some military shadows into patchy or mass liked shadow, diffusely distributed lung lesions', 'hash': '3bf8714e005c1ebc72eb46fac228838fd6436f0a1dd5d6a8bd085a14fddd1170'}, {'image_id': '313891_1_En_17_Fig69_HTML', 'image_file_name': '313891_1_En_17_Fig69_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig69_HTML.jpg', 'caption': '(a, b) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the medial basal segment of the right lower lung, irregular nodular shadows in the cavities, and surrounding fused miliary infiltration shadows', 'hash': 'db839a28accf7944530e9940a7c7afb2b7b3c7a4423308b863fae87f0c08c29a'}, {'image_id': '313891_1_En_17_Fig80_HTML', 'image_file_name': '313891_1_En_17_Fig80_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig80_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a, b) Anteroposterior and lateral DR demonstrate a huge dense mass shadow in the left lower lung, with clear boundary. (c) CT scanning of the pulmonary window demonstrates round liked high density shadow in the left lower lung near left chest wall, with even density. (d) CT scanning of the mediastinal window demonstrates round liked soft tissue density shadows in the left lower lung near left chest wall, with even density, lobulation, and surrounding thick spikes', 'hash': 'ea2ef199cee39dce2b4a8a06bcdcce274a6fd8796c2efbfaf940d6d05fe48c40'}, {'image_id': '313891_1_En_17_Fig43b_HTML', 'image_file_name': '313891_1_En_17_Fig43b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig43b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related tuberculous pleuritis. (a) DR demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (b) CT scanning of the pulmonary window demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (c) CT scanning of the mediastinal window demonstrates encapsulated fluid density shadow in the pleura of the right lateral chest wall', 'hash': '582e0f2e161551b97de13a60d6afed8cc613b9b04bfb136458587da830b2ecf0'}, {'image_id': '313891_1_En_17_Fig16_HTML', 'image_file_name': '313891_1_En_17_Fig16_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig16_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple fibrous cords liked shadows in lungs, multiple patchy parenchyma shadows and ground glass liked density shadows in both upper lobes, with multiple transparent areas in them. The bronchial walls are thickened in the anterior and posterior segments of the right upper lobe as well as in the lingual segment of the left lung', 'hash': '214979f5c447a9b40ebd0772cff663eb275052bf5fe8132456329ffacdc20c9c'}, {'image_id': '313891_1_En_17_Fig109_HTML', 'image_file_name': '313891_1_En_17_Fig109_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig109_HTML.jpg', 'caption': '(a, b) HIV/AIDS related lymphoma. (a, b) CT scanning demonstrates a huge soft tissue mass shadow in the left lateral chest wall, with a maximal size of about 7.7\u2009×\u200913.0 cm and occupying 30 sections with 8 mm in thickness of each section and with the upmost to the supraclavicular area and the bottom in the level of thoracic 12th vertebral body in the lower chest wall. There are also large quantity left pleural effusion and parenchymal changes of the left lower lobe with atelectasis. In the left chest cavity, large quantity liquid density shadows can be found, with compressed lung tissues to the hilum. By puncture and biopsy of the subaxillary mass, the diagnosis is defined as diffuse large B cell lymphoma', 'hash': '6d67a094843ca970dc50c93d50e7d1038c2a389c96e1772f425fa9dbc9d3a3ea'}, {'image_id': '313891_1_En_17_Fig19_HTML', 'image_file_name': '313891_1_En_17_Fig19_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig19_HTML.jpg', 'caption': '(a) Gross observation in autopsy demonstrates disseminated pulmonary tuberculosis, with grayish white military nodules in diffuse distribution in the lung tissues section. (b) It is demonstrated that mycobacteriumavium-intracellularcomplex infection in the lung tissue, with atypical tuberculosis nodules and acid-fast staining positive (left top). There are a subnodular giant cell, eosinophilic inclusion bodies in the nucleus and bradyzoites in cytoplasm of T. gondii. HE\u2009×\u2009100. (c) HE demonstrates mycobacteriumavium-intracellularcomplex infection, with atypical tuberculosis nodular changes, HE\u2009×\u2009200', 'hash': 'fac712a77d78563a8ebac012fe6c9f2f74ab72b1d36bf9e0c30462450f24c87d'}, {'image_id': '313891_1_En_17_Fig92a_HTML', 'image_file_name': '313891_1_En_17_Fig92a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig92a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs', 'hash': '981e19f8709c64fb0f850afd293a3dfdb67ec16a8d75e3f2bf19cd69116366cd'}, {'image_id': '313891_1_En_17_Fig41_HTML', 'image_file_name': '313891_1_En_17_Fig41_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig41_HTML.jpg', 'caption': 'HIV/AIDS related tuberculous pleuritis. DR demonstrates arch shaped dense shadows with higher exterior density and lower interior density in the right lower lung field and covered right edge of the heart', 'hash': '3381f76804304950a36ba44865a5651168e2f9b43c451a23d390d065bfc52e80'}, {'image_id': '313891_1_En_17_Fig56a_HTML', 'image_file_name': '313891_1_En_17_Fig56a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig56a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates huge round large flaky shadows with increased density in the left lower lung, enlarged and thickened hilum and covered right heart edge. (c, d) DR reexamination after treatment for 1 week demonstrates flocculent shadow in the left lower lung, improved than those before the treatment (a, b). (e) DR reexamination after treatment demonstrates flocculent liked shadows in the left lower lung, obviously improved than before the treatment (c, d)', 'hash': '8c2f7c50d0562920efd9257451f8cc2d4dda042eaa3768d3fb1455a7092edf94'}, {'image_id': '313891_1_En_17_Fig93a_HTML', 'image_file_name': '313891_1_En_17_Fig93a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig93a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates diffuse small cavity in honeycomb liked and infiltrative parenchyma shadows, with the hilum as the center to distribute bilaterally symmetric like butterfly wings; multiple honeycomb liked cavity shadows in both lungs. (e–h) CT scanning reexamination demonstrates large irregular thick-wall cavities in the right lung, surrounding scattering nodular, honeycomba liked and infiltrative shadows after anti-PM infection treatment for 3 months', 'hash': 'eb824267db9288c03e6cffae4cde8b6f47b3bda47dcad797ee4964b9011ac598'}, {'image_id': '313891_1_En_17_Fig46b_HTML', 'image_file_name': '313891_1_En_17_Fig46b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig46b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates large flaky dense shadows in the middle-outer zone of the left middle lung field, and narrowed left bronchus. (d–f) CT scanning demonstrates large flaky shadows with uneven density in the left lateral chest wall and even lower density shadow in them', 'hash': '97eaf0337e0212b917644691da5093524803db5d92384afd57bfc5803cb125e0'}, {'image_id': '313891_1_En_17_Fig39_HTML', 'image_file_name': '313891_1_En_17_Fig39_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig39_HTML.jpg', 'caption': '(a–d) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung, periphery crab feet liked or cords liked shadows due to pleural traction and satellite lesions. (c, d) CT scanning of the mediastinal window demonstrates round liked or triangle shaped thick wall cavities in the left upper lung, no nodules in the wall and peripheral nodular satellite lesions', 'hash': '614dd89032a813e240901110905f63b8b8d2530c6c7e27b0e6aab03ce47f7abb'}, {'image_id': '313891_1_En_17_Fig61_HTML', 'image_file_name': '313891_1_En_17_Fig61_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig61_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a) DR demonstrates large flaky shadow in the middle-outer zone of the left upper lung field. (b) DR demonstrates diffuse dense shadow in the left lung field, with round liked cavities shadows in them. (c–d) Reexamination after treatment demonstrates multiple cavities shadows in the middle-outer zone of the left upper lung field', 'hash': '29c84b1869c0cdabc91ee8822b014d024780586503e92fa0fdc6bed1d3b54b73'}, {'image_id': '313891_1_En_17_Fig88_HTML', 'image_file_name': '313891_1_En_17_Fig88_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig88_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a) The gross specimen demonstrates central necrotic pimples on the face. (b) Chest X-ray DR demonstrates cavities in the left upper lung, thickened lung markings in both lower lungs with accompanying multiple spots and flakes shadows. (c) Gastrointestinal barium meal radiology demonstrates left and downwards migration of the intestine due to compression. (d) Enhanced abdominal CT scanning demonstrates retroperitoneal enlarged lymph nodes that fuse into a huge mass, with ring shaped enhancement of the lymph nodes', 'hash': '72d6f61ccf9268cf07530a5a1e56a768d1d614ac854706838e783fa20f2cb2a1'}, {'image_id': '313891_1_En_17_Fig87_HTML', 'image_file_name': '313891_1_En_17_Fig87_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig87_HTML.jpg', 'caption': '(a) HE staining demonstrates lymph nodes, PM in the yeast phase, with sausage liked shape and obvious septa (HE\u2009×\u20091000). (b) GMS staining demonstrates clearly defined PMs (GMS\u2009×\u20091,000)', 'hash': '195e16d569e89c659459764942f07ae44cec9cd1fd8634e716178e34225094ab'}, {'image_id': '313891_1_En_17_Fig91a_HTML', 'image_file_name': '313891_1_En_17_Fig91a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig91a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–e) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of some lesions into honeycomb likes cavity shadows or plaque liked dense shadows. (f–h) CT scanning demonstrates large thick-wall cavity shadows in the right lung, surrounding plaque and round liked small cavity shadows and inflammatory infiltrative shadows', 'hash': '84aa8353e64cbf735c399fa64899ecd1e9b8a13620149a5aa662a21a423c07bf'}, {'image_id': '313891_1_En_17_Fig8b_HTML', 'image_file_name': '313891_1_En_17_Fig8b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig8b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates large flaky parenchyma shadows in both lungs which is more obvious in the middle and lower lobes of both lungs. There are also enlarged hilar shadows in both lungs and sharp both costophrenic angles. (b–g) CT scanning demonstrates large flaky parenchyma shadows in concentric and symmetrical distribution, bronchial shadows in them and thickened bronchial walls', 'hash': '812cc7d7992507bc22a7c06e518ff223d7e9ece757725f478a6f723b8ac030bf'}, {'image_id': '313891_1_En_17_Fig29_HTML', 'image_file_name': '313891_1_En_17_Fig29_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig29_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric and in even size and distribution. There are nodular shadows in the anterior segment of the right middle lung lobe with clear boundary', 'hash': '16cd873b8d84d3bbad635d9facea5407fe900b62efdd6f481449f4a433dfb6a0'}, {'image_id': '313891_1_En_17_Fig71_HTML', 'image_file_name': '313891_1_En_17_Fig71_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig71_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary aspergillosis infection. (a) The gross specimen demonstratesAspergillus abscess in the skin of the forearm. (b–d) CT scanning of the pulmonary window demonstrates multiple round liked nodular shadows and cavity shadows in both lungs, even thickness of cavity wall, and small nodular shadows in some cavities. (e) Pulmonary Aspergillus infection, demonstration purplish blue branches liked or grasses liked growth of hyphae, HE\u2009×\u2009400', 'hash': 'f0586168fbf7b2cd35205e1c807a3343af1ec5bac8dbe4f50308a570cd7d3552'}, {'image_id': '313891_1_En_17_Fig97_HTML', 'image_file_name': '313891_1_En_17_Fig97_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig97_HTML.jpg', 'caption': '(a) Gross observation of the fresh specimen in autopsy demonstrates pulmonary edema and congestion of cytomegalovirus pneumonia. (b) Gross observation of the formalin fixed specimen in autopsy demonstrates dark brown hard pulmonary tissues. (c, d) HE staining demonstrates large quantity cytomegalovirus inclusions in eagle eyes sign. (e) Immunohistochemical demonstrates HIV P24 antigen positive in macrophages of lung tissues (×400)', 'hash': '50e144edf7881be15e502fff23c2613760ac0172fe3ae6c56abf5ca1abf085b5'}, {'image_id': '313891_1_En_17_Fig20_HTML', 'image_file_name': '313891_1_En_17_Fig20_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig20_HTML.jpg', 'caption': '(a, b) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates enlarged right hilum in nodular dense shadows with peripheral thickened and blurry pulmonary markings, and no obvious abnormalities of the left hilum. (b) DR demonstrates smaller right hilum after treatment for 1 month', 'hash': '27213b483e54de634de857225fc93f6dc05eb5a729bc751141dea3866128c8ec'}, {'image_id': '313891_1_En_17_Fig6b_HTML', 'image_file_name': '313891_1_En_17_Fig6b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig6b_HTML.jpg', 'caption': '(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe', 'hash': 'ba6f221be2db1160358ae94e02b0125159adca1d9ac64bff84883eae8b614970'}, {'image_id': '313891_1_En_17_Fig17b_HTML', 'image_file_name': '313891_1_En_17_Fig17b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig17b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchymal shadows and fibrous cords liked shadows in both lungs which are more obvious in both lower lungs. The trachea and bronchi are unblocked, with enlarged hilar shadows in both lungs', 'hash': 'dba27067e12ab2a752ec8a543537f427156b1a18bdc04bffa3aedbe2d3b6e7bd'}, {'image_id': '313891_1_En_17_Fig113a_HTML', 'image_file_name': '313891_1_En_17_Fig113a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig113a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Kaposi’s sarcoma. (a–d) Chest CT scanning demonstrates scattered cloudy, mass and flake liked or nodular shadows with increased density. (e) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large thick stained nucleoli, which are in line with the diagnosis of Kaposi’s sarcoma. (f–i) Cured HIV/AIDS related Kaposi’s sarcoma. (f–i) Reexamination after treatment demonstrates absent lesions in both lungs, with clear lung fields', 'hash': '192d991df0d417610162aab90c8b0e07b4c19f1436faa752263e85c3efa0f3db'}, {'image_id': '313891_1_En_17_Fig77_HTML', 'image_file_name': '313891_1_En_17_Fig77_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig77_HTML.jpg', 'caption': 'HE staining demonstrates isseminated cryptococci, the Cryptococcus is stained red after mucin carmine staining of cryptococcus neoformans spores in lungs, (HE\u2009×\u2009200)', 'hash': '882060c6f53899fb225a20d7eb5fe410195beed0a7386dc233a4632284f4717f'}, {'image_id': '313891_1_En_17_Fig78_HTML', 'image_file_name': '313891_1_En_17_Fig78_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig78_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates multiple scattered nodular and miliary shadows in both lungs. (b–d) Chest CT scanning demonstrates multiple dense nodular shadows with different sizes in both lungs, with clear boundaries. They are intensively distributed in the dorsal segment and the largest one has a diameter of about 2 cm', 'hash': 'd60cf04886c28c578ee7940f50525d5141254a1a45a5b489d53a7ae5ae27fa53'}, {'image_id': '313891_1_En_17_Fig7b_HTML', 'image_file_name': '313891_1_En_17_Fig7b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig7b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates diffusely distributed shadows with increased density in both lungs that is more obvious in the middle and lower lungs. The hilar shadows in both lungs are enlarged. Both diaphragmatic surfaces and phrenic angles are blurry. (b–d) CT scanning demonstrates flaky shadows with increased density in both lungs, with parenchymal shadows in the lingular segment of left upper lobe and in the dorsal segments of both lower lobes and bronchial shadows in them. There are also thickened bronchial walls and enlarged hilar shadows in both lungs', 'hash': '47bf3b06e99aa6482027b30084d7445e95928d39923c99fd8fe93df39c899b2d'}, {'image_id': '313891_1_En_17_Fig30_HTML', 'image_file_name': '313891_1_En_17_Fig30_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig30_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs and fusion of some military shadows, which are bilaterally symmetric and in even size and distribution', 'hash': 'ab1d4160a6a23300146e331c7eee06edf886ca73ab4514f8a59b22d04d3c303f'}, {'image_id': '313891_1_En_17_Fig1_HTML', 'image_file_name': '313891_1_En_17_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig1_HTML.jpg', 'caption': '(a) Gross specimens’ observation demonstrates foamy liquid filling in the lung tissues. (b) HE demonstrates pneumocystis in the alveolar exudates, which can be stained black by silver methenamine staining, ×400. (c) HE demonstrates the foamy substance in the alveolar space, ×400', 'hash': 'a0082be568f7c995671d0461acf0cfe32c8c36a01dbf7badc28f3cc0ab407b75'}, {'image_id': '313891_1_En_17_Fig81_HTML', 'image_file_name': '313891_1_En_17_Fig81_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig81_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates thickened lung markings in both lungs and flaky blurry shadows in the left lower lung. (b, c) CT scanning demonstrates round liked nodular and small cavity shadows in the left upper and lower lung, with clear boundaries. (d–f) Pathology demonstrates transparent substrate in lung tissues and many bi-capsular cryptococci in cytoplasm', 'hash': '3e767fbaeda72c7b7b49df4ee9daa757367932f7623507185ca8453615c8de74'}, {'image_id': '313891_1_En_17_Fig58a_HTML', 'image_file_name': '313891_1_En_17_Fig58a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig58a_HTML.jpg', 'caption': '(a–i) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) CT scanning of the pulmonary window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (c, d) CT scanning of the mediastinal window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, pulmonary atelectasis and pleural effusion, with ventilation shadows in them. (e) CT scanning of the pulmonary window after the treatment demonstrates absence of the mass shadows in the left lower lung with transverse stripes shadows, obviously improved than previous findings (a, b). (f) HE staining demonstrates thickened alveolar septa and exudates from the alveolar cavity. (g) HE staining demonstrates massive bleeding in the alveolar cavity, large quantity erythrocytes and intact cell walls. (h) HE staining demonstrates phagocytized basophilic granules in the leukocytes. (i) HP staining demonstrates purplish red Rhodococcus equi in a shape of crescent in orange red sputum', 'hash': 'fcd60ca09d86084cb78d6b91f9b3e0a51e9f479a1c27837e18c9af0f809ef13d'}, {'image_id': '313891_1_En_17_Fig57_HTML', 'image_file_name': '313891_1_En_17_Fig57_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig57_HTML.jpg', 'caption': '(a, b)HIV/AIDS related Rhodococcus equi pneumonia. (a) CT scanning of the mediastinal window demonstrates soft tissue mass shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (b) CT scanning of the pulmonary window after the treatment demonstrates absence of the soft tissue mass shadows, and flocculent liked shadow in the left lower lung, obviously improved than previous findings (a)', 'hash': '9ac02a8eb30f8314fea4211fa5a4dbfa3863c422d30e78fcb26e8eaf44e36a42'}, {'image_id': '313891_1_En_17_Fig10_HTML', 'image_file_name': '313891_1_En_17_Fig10_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig10_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates large flaky and mass liked parenchyma shadows in both lungs which is more obvious in the right lung, bronchial shadows in them, and thickened bronchial walls in the middle lobe of the right lung', 'hash': 'dc81224c041dbc53a26ff01b3414f8c13098126861cf7cc0c7f10d80a7485e0c'}, {'image_id': '313891_1_En_17_Fig100_HTML', 'image_file_name': '313891_1_En_17_Fig100_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig100_HTML.jpg', 'caption': 'The structure of herpes simplex virus', 'hash': 'b0a88fbe1660ab4ddb94799e876d547c23b5686d12e31560768111a38bc71a45'}, {'image_id': '313891_1_En_17_Fig110a_HTML', 'image_file_name': '313891_1_En_17_Fig110a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110a_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '7392286985c0e8fefacf1282d1ef323dd6d64b0b536b667dfffbcbde5be28d3c'}, {'image_id': '313891_1_En_17_Fig5b_HTML', 'image_file_name': '313891_1_En_17_Fig5b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig5b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates patchy shadows with increased density in both lungs, with thickened hilar shadows in both lungs. (b–g) CT scanning demonstrates flaky ground glass liked density shadows in upper lungs and dorsal segment of both lungs, which is more obvious in the middle inner strips. There are extrapulmonary stripes transparent shadows, with some bronchial walls thickened and enlarged hilar shadows in both lungs', 'hash': 'fcd873302d30f9846ba865346820af2a06778c5dad1b50cc634281055ae78468'}, {'image_id': '313891_1_En_17_Fig47_HTML', 'image_file_name': '313891_1_En_17_Fig47_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig47_HTML.jpg', 'caption': '(a–e) HIV/AIDS related staphylococcus aureus pneumonia. (a) DR demonstrates large flaky dense shadows with increased density in the middle-inner zone of the left upper lung field, with blurry boundaries. The lung tissue are atelectatic and the mediastinum migrates leftwards. (b, c) CT scanning demonstrates large flaky dense shadows with increased density in the middle-inner zone of the left upper lung field, with blurry boundaries, with surrounding acinar or particle liked shadows that fuse into flaky shadows. (d, e) CT scanning demonstrates large flaky shadow of parenchymal changes in the middle-inner zone of the left upper lung field, with cyst liked transparent shadows and air bronchogram sign in them, as well as mediastinal lymphadenectasis', 'hash': '8e228a648d0d33ebe1db2bfa2fa7b6209cd113683b027d6ada34f161b809085a'}, {'image_id': '313891_1_En_17_Fig48_HTML', 'image_file_name': '313891_1_En_17_Fig48_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig48_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates broad band liked high density shadows in the right middle lung field, with air bronchogram sign in them. (d–f) CT scanning of the mediastinal window demonstrates broad band liked uneven parenchymal shadows in the right middle lung field, with uneven thickness of air bronchogram sign', 'hash': '6e700dc830efe216b64ed069dfb6440abf50854341b133bf0237be914bd5270f'}, {'image_id': '313891_1_En_17_Fig37_HTML', 'image_file_name': '313891_1_En_17_Fig37_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig37_HTML.jpg', 'caption': '(a, b) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a, b) DR demonstrates diffuse scattering patchy shadows with increased density, and oval thin wall cavity shadows in the right middle lung field', 'hash': 'edc3511f0cc30005fb5999c1fe7033024176b0e1b8fee607763caef6a0d9abe2'}, {'image_id': '313891_1_En_17_Fig38_HTML', 'image_file_name': '313891_1_En_17_Fig38_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig38_HTML.jpg', 'caption': '(a–d) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in both upper lungs, peripheral crab feet liked or cords liked shadows due to pleural traction with cavity shadows in them and periperal satellite lesions. (b–d) CT scanning of the mediastinal window demonstrates round liked mass shadows with high density in the cavities of the left upper lung, surrounding transparent shadows, no nodules in the walls and surrounding nodular satellite lesions. By pathological examination, the diagnosis is defined as chronic fibrous cavity pulmonary tuberculosis complicated by Aspergillus infection', 'hash': '0317a9a78d280af1069a5b797b63c3817f47607eb13976214ed710d247081a7c'}, {'image_id': '313891_1_En_17_Fig65b_HTML', 'image_file_name': '313891_1_En_17_Fig65b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig65b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related allergic pulmonary Aspergillus infection. (a–f) CT scanning of the pulmonary window demonstrates thickened central pulmonary markings in both lungs, which is turtuous and deranged with fingertip infiltration shadows. (g) DR demonstrates hyperinflation of the right lung, increased and thickened pulmonary markings and ground glass liked shadows with increased density in the right lower lung and left lung lobe', 'hash': '44f320a9216b7a9905eaaa045a44b4be59372433c9737f0ee8ded7c443134eaa'}, {'image_id': '313891_1_En_17_Fig9_HTML', 'image_file_name': '313891_1_En_17_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig9_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates large flaky parenchyma shadows in both lungs, with transparent areas in some foci. The trachea and bronchi are unblocked, with thickened bronchial walls in the middle and lower lobes', 'hash': '26b10397cecf70e4665c1abb0f2501e939a6e5d219f395c3484c7a44dae78681'}, {'image_id': '313891_1_En_17_Fig76a_HTML', 'image_file_name': '313891_1_En_17_Fig76a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig76a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning demonstrates diffuse scattered thin ground glass liked, patchy, flaky blurry shadows and cords liked shadows in both lungs, with blurry boundaries and uneven density; scattered nodular shadows in different sizes; more lesions in both upper lobes and the right middle lobe; flaky parenchyma shadows in the apical and posterior segments of right upper lobe, with air bronchogram sign in them; unobstructed opening of bronchi as well as lobar and segmental bronchi without stenosis and obstruction; lymphadenectasis in the right hilar region; detected Aspergillus fumigatus by sputum culture. (e, f) Culture for 72 h, lactic acid gossypol blue staining and microscopic observation at ×200 and ×400 demonstrate short column liked conidial head, smooth wall of conidiophores, flask-shaped top capsule and monolayer microconidiophores. (g) Culture in Paul’s medium demonstrates dark green colored colonies', 'hash': '79dde610127d242cc7f1f29fc98dd50c426df080c95629396102af54f31872c9'}, {'image_id': '313891_1_En_17_Fig86_HTML', 'image_file_name': '313891_1_En_17_Fig86_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig86_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary candida infection. (a–d) CT scanning demonstrates thickened and deranged lung markings in both lungs, diffuse small flaky or patchy shadows, fusion of some small shadows into large flaky dense shadows, with blurry boundaries, enlarged hilum and blurry structures', 'hash': 'bb5525804e3b5cc6588115cd2813109845df9b4314974ab2b55c40298ed6968a'}, {'image_id': '313891_1_En_17_Fig89_HTML', 'image_file_name': '313891_1_En_17_Fig89_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig89_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows in the lungs that fuse into mass with parenchymal shadows, with the hilum as the center and distributing bilaterally symmetric like butterfly wings. There are also multiple clustering cavities or singular large cavity in both lungs', 'hash': 'cfd1927b986a8aba818bf96427711a3743dd07195a83b88e195837af405aae79'}, {'image_id': '313891_1_En_17_Fig60_HTML', 'image_file_name': '313891_1_En_17_Fig60_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig60_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a) DR demonstrates huge sphere liked mass shadow in the middle-outer zone of the right lower lung field, with cavities shdows in them. (b–d) CT scanning demonstrates triangular dense shadow in the middle-outer zone of the right lower lung field, with its apex pointing to the hilum and round liked cavities shadows in them. (e) Reexamination after the treatment demonstrates shrinkage of the huge sphere liked mass shadow in the middle-outer zone of the right lower lung field, with closure of the cavities', 'hash': '9020727e51b9a8522ea37dd579ce73bd9a417d327bcb313836c96e1fa3bd209f'}, {'image_id': '313891_1_En_17_Fig2b_HTML', 'image_file_name': '313891_1_En_17_Fig2b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig2b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered miliary increased density shadows in both lungs, with even size, density and distribution. The shadows of both hila are dense, with sharp both costophrenic angles. (b–f) CT scanning demonstrates scattered miliary nodular shadows in both lungs, which is more obviously in the middle pulmonary strip and with quite even size and density. Trachea and bronchi are unblocked', 'hash': 'ab808d6adb73be9c9efd977cd27ef54cace943f5143068db354c7d287374a50d'}, {'image_id': '313891_1_En_17_Fig13b_HTML', 'image_file_name': '313891_1_En_17_Fig13b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig13b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, transparent areas in them and unblocked trachea and bronchi', 'hash': '2f728d8163ffe4c88ed77f38f8d2e52cb2281b7f3a54af1e9ef328c17a26db3e'}, {'image_id': '313891_1_En_17_Fig28_HTML', 'image_file_name': '313891_1_En_17_Fig28_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig28_HTML.jpg', 'caption': '(a–b) HIV/AIDS related miliary tuberculosis. (a) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric and in even size and distribution. (b) CT scanning of the mediastinal window demonstrates round liked nodular shadows in the right lower lung. CT guided puncture for biopsy is performed to define the diagnosis', 'hash': '1ae71db3f6eebb2e460b8f3b777873d5e7fcf066436bf3a85ef8123aff3f39a9'}, {'image_id': '313891_1_En_17_Fig105b_HTML', 'image_file_name': '313891_1_En_17_Fig105b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig105b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary toxoplasmosis. (a–d) CT scanning demonstrates thickened pulmonary markings in both lungs, which can be enhanced to extend into the middle and outer zones of lungs, in grid liked appearance that is more obvious in the dorsal segment of the lungs. (e) It is demonstrated to have clustering toxoplasma tachyzoites', 'hash': '78ad5a602c243399be530b578f5858d7393984c75f2f978c1dd02f12b26b8836'}, {'image_id': '313891_1_En_17_Fig99_HTML', 'image_file_name': '313891_1_En_17_Fig99_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig99_HTML.jpg', 'caption': '(a, b) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates enlarged right hilus, thickened and deranged lung markings. (b) Plain CT scanning demonstrates mass shadows in the right hilus, spots shadows in the right middle and lower lobes, and patchy shadows in the lingual segment of the left lung', 'hash': '996d2e340f8971525deb4ef2a9312fe4a696f4d7f6bf28ca091e8c767b96b1d4'}, {'image_id': '313891_1_En_17_Fig3b_HTML', 'image_file_name': '313891_1_En_17_Fig3b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig3b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy and scattered miliary increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of the lower lung field, with some fused in thin cloudy shadows', 'hash': '8c1d9dac035274e484303c9deb64a07fed7806c66acaf49b860164feb6d461fc'}, {'image_id': '313891_1_En_17_Fig70_HTML', 'image_file_name': '313891_1_En_17_Fig70_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig70_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window demonstrates a huge cavity shadow in the dorsal segment of the right lower lung, large nodular shadows in it, liquid gas level in the basal cavity, and the evenly thick wall. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates a huge cavity shadow in the dorsal segment of the left lung, multiple large nodular shadows in it, and involved pleura of the lateral chest wall', 'hash': '967426acae68b8d57372efde07d76dd6ad696b10cc5bb64fb67bd9af43a1b0c8'}, {'image_id': '313891_1_En_17_Fig108_HTML', 'image_file_name': '313891_1_En_17_Fig108_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig108_HTML.jpg', 'caption': 'HIV/AIDS related lymphoma. DR demonstrates widened upper middle mediastinum in a dense shadow, enlarged and thickened hilum, thickened and blurry pulmonary markings with diffuse ground glass liked changes', 'hash': '449c992b619237febe63b1617b26f78de511c69c5d1c86ddbd66631790a3e3ce'}, {'image_id': '313891_1_En_17_Fig18_HTML', 'image_file_name': '313891_1_En_17_Fig18_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig18_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates multiple patchy shadows with increased density in both lungs which are more obvious in both middle and lower lungs. The hilar shadows in both lungs are enlarged, with sharp both costophrenic angles. (b–d) CT scanning demonstrates multiple patchy and mass liked parenchyma shadows in both lungs, ground glass density shadows in the apical segment of both upper lobes, transparent areas in the medial segment of the right middle lobe as well as in the lingual segment of the left upper lobe, and unobstructed trachea and bronchi', 'hash': '18239548bfc8a180d3460173e2f66f27c6ff38e464607d7ec3eb2a837a1382c9'}, {'image_id': '313891_1_En_17_Fig67b_HTML', 'image_file_name': '313891_1_En_17_Fig67b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig67b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows. (e–h) Reexamination of the pulmonary window after 3 months treatment demonstrates multiple scattered round liked nodular shadows and thick wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows which obviously increase and enlarge compared to previous lesions, with accompanying infiltration shadows around the lesions', 'hash': 'f70faec5b814f1fa9555182e0f5414a33838b2496e4da16dc69e0c237676eb30'}, {'image_id': '313891_1_En_17_Fig115a_HTML', 'image_file_name': '313891_1_En_17_Fig115a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig115a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lung cancer. (a–f) CT scanning demonstrates diffuse soft tissue density shadows in left upper lung, round liked mass shadows in the middle lung field, thickened pleura in the lateral chest wall with adhesion, and strip liked liquid density shadows', 'hash': '08de7c80ca9fdc7641723bbb9689498f65631a1a2ee1f499cda653be3ea3d358'}, {'image_id': '313891_1_En_17_Fig40_HTML', 'image_file_name': '313891_1_En_17_Fig40_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig40_HTML.jpg', 'caption': '(a, b) HIV/AIDS related endobronchial tuberculosis. (a, b) Chest CT scanning demonstrates narrowed left major bronchus, irregular thickening of the brounchial wall, multiple irregular flaky, patchy and military shadows in the posterior apical, anterior and lingual segments of the left upper lung. Bronchobierscopy demonstrates narrowed left major bronchus, which is possibly caused by endobronchial tuberculosis', 'hash': '4e416b52d4cb1a2790ee8ad419d525b4e0b37740624cb136f4f5d66c98344651'}, {'image_id': '313891_1_En_17_Fig106b_HTML', 'image_file_name': '313891_1_En_17_Fig106b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig106b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related lymphoma. (a–b) DR demonstrates enlarged and thickened left hilum in a huge mass shadow. High KV demonstrates a huge mass shadow in the hilum. (c–h) CT scanning of the pulmonary window demonstrates a huge high density mass shadow in the left hilum, surrounding nodular fusion shadows in the lung tissues. CT scanning of the mediastinal window demonstrates a huge high density mass shadow in the left hilum, with air bronchogram sign in the shadow', 'hash': '157c65f2ce36513c7bad3d16abf703fde23671a6d95e1da5b62342efd5b516bb'}, {'image_id': '313891_1_En_17_Fig75a_HTML', 'image_file_name': '313891_1_En_17_Fig75a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig75a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval or sphere shaped nodular shadows in the cavities with smooth boundaries. (e, f) Reexamination after treatment demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval nodular shadows in the cavity with smooth boundaries. Compared to the previous imaging findings, the lesions are shrunk, with improved surrounding infiltration', 'hash': 'd2c91d61cbf8a801eed1951a78b54e9b966e9be37aee83d7582af7a496143832'}, {'image_id': '313891_1_En_17_Fig66b_HTML', 'image_file_name': '313891_1_En_17_Fig66b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig66b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates large flaky shadows with increased density in the right upper lung, with blurry boundaries; round liked or sphere shaped mass shadows in the right lower lung, with uneven density. (b–e) CT scanning of the pulmonary window demonstrates multiple round liked thick-wall cavities in the dorsal segment of the right lower lung, with small nodular shadow adhering on the cavity wall; and surrounding small nodular shadows and infi ltration shadows. (f, g) Coronal CT scanning reconstruction demonstrates a huge thick-wall cavity in the right upper lung, with irregular thickness of the wall; round liked cavity shadows in the right lower lung, with thick and multilocular walls; and flaky shadows with increased density in the outer zone of the left lower lung', 'hash': 'fe0cc9e767d47fe24d043db5792869e260b44f40097a6c4d26c923e91ef70b0b'}, {'image_id': '313891_1_En_17_Fig98a_HTML', 'image_file_name': '313891_1_En_17_Fig98a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig98a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates thickened lung markings in both lungs, which extend to the outer zone of the lungs. (b) DR demonstrates thickened and deranged lung markings in both lungs with nodular blurry shadows; and cloudy shadows in lung fields. (c, d) CT scanning demonstrates thickened lung markings in both lungs, with diffuse nodular shadows; and cloudy changes in lung fields. (e) HE staining demonstrates cytomegalovirus inclusions', 'hash': 'adcabf812efa2a551bb7a968e7cf0afcc7677ffb9adf3d1a40a65675496e4552'}, {'image_id': '313891_1_En_17_Fig50_HTML', 'image_file_name': '313891_1_En_17_Fig50_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig50_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Staphylococcus aureus pneumonia. (a) DR demonstrates large flaky dense shadow in the right middle-upper lung field, with blurry boundary. (b, c) CT scanning demonstrates large flaky dense shadow in the right middle upper lung field, with blurry boundary. (d, e) CT scanning demonstrates large flaky dense shadow in the right middle upper lung field, with cystic transparent area in it. (f) Reexamination demonstrates obviously improved pulmonary lesions in the right lung after anti-bacteria treatment for 3 weeks', 'hash': 'bb5e00f8d7a7c6c4308ca4e5024daa75df1bf9a0a88359faa7e2ee91a6c5f156'}, {'image_id': '313891_1_En_17_Fig114a_HTML', 'image_file_name': '313891_1_En_17_Fig114a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig114a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related Kaposi’s sarcoma. (a–d) CT scanning demonstrates scattered cloudy mass and flakes liked or nodular shadows with increased density in both lungs with uneven density and unclear boundaries, fusion and parenchymal changes of some lesions, more lesions in the lower lobe of both lungs and mostly with parenchymal changes. (e, f) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large and thick stained nucleoli, which are in line with the manifestations of Kaposi’s sarcoma. (g, h) Immunohistochemical demonstrates positive of C3 and C4', 'hash': '5d7437deda7758de05e56f8172703b4659fa4eeebdc50c92456867e7bfdb2691'}, {'image_id': '313891_1_En_17_Fig107b_HTML', 'image_file_name': '313891_1_En_17_Fig107b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig107b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related lymphoma. (a–e) CT scanning of the pulmonary and mediastinal windows demonstrates multiple round liked nodular shadows with increased density in both lung fields, with clear boundaries; large soft tissue mass shadows in the right lower lung, with slightly lobulated boundaries and spikes. (f–i) CT scanning of the pulmonary and mediastinal windows for reexamination after radiation therapy demonstrates shrinkage of intrapulmonary nodules and masses', 'hash': 'a7c148d3f71f853c603d1730a516c4b571960bd1e6296b96b6418a73f3663e33'}] | {'313891_1_En_17_Fig1_HTML': ['By naked eyes observation, there are extensive and diffuse invasion of lungs, which is soft like waterlogged sponge and in milky white with black spots. The filled foamy substance in the alveoli and bronchioles is a mixture of necrotic fungus and immunoglobulin. The alveolar septum has infiltration of plasma cells and lymphocytes, resulting in thickened alveolar septa up to 5–20 times as the normal thickness that occupy 3/4 of the entire lung volume. The cysts are firstly located in the macrophage cytoplasm of the alveolar septa. Subsequently, the alveolar cells containing cysts sheds off into the alveolar space. After the rupture of the cystic wall, sporozoite is discharged to turn into free trophozoites, which gains its access into the alveolar space. The alveolar exudates include plasma cells, lymphocytes and histocytes (Fig. <xref rid="313891_1_En_17_Fig1_HTML" ref-type="fig">17.1a–c</xref>).\n).\nFig. 17.1(a) Gross specimens’ observation demonstrates foamy liquid filling in the lung tissues. (b) HE demonstrates pneumocystis in the alveolar exudates, which can be stained black by silver methenamine staining, ×400. (c) HE demonstrates the foamy substance in the alveolar space, ×400\n'], '313891_1_En_17_Fig19_HTML': ['If the necrotic lesions erode the blood vessels, tubercle bacilli can cause systemic miliary tuberculosis along with blood flow, including brain, bones and kidneys. Large quantity sputum containing tubercle bacilli gains its access into the gastrointestinal tract. It can also cause intestinal tuberculosis and peritoneal tuberculosis. Pulmonary tuberculosis can cause tuberculosis pleurisy via direct spreading to the pleura (Fig. <xref rid="313891_1_En_17_Fig19_HTML" ref-type="fig">17.19a–c</xref>).\n).\nFig. 17.19(a) Gross observation in autopsy demonstrates disseminated pulmonary tuberculosis, with grayish white military nodules in diffuse distribution in the lung tissues section. (b) It is demonstrated that mycobacteriumavium-intracellularcomplex infection in the lung tissue, with atypical tuberculosis nodules and acid-fast staining positive (left top). There are a subnodular giant cell, eosinophilic inclusion bodies in the nucleus and bradyzoites in cytoplasm of T. gondii. HE\u2009×\u2009100. (c) HE demonstrates mycobacteriumavium-intracellularcomplex infection, with atypical tuberculosis nodular changes, HE\u2009×\u2009200\n'], '313891_1_En_17_Fig45_HTML': ['Pneumonia caused by inhaled staphylococcus aureus through the respiratory tract often shows lesions in the large lobes or extensive fusion of bronchopneumonia lesions. Bronchial and alveolar rupture allows gas to enter the pulmonary interstitium, which is communicated with the bronchi. In the cases of bronchiolar blockage by necrotic tissues or pus, the one-way valve effect is formed to cause tension pulmonary emphysema. In the cases with superficial pulmonary emphysema with excessively high tension, it ruptures to form pneumothorax or pyopneumothorax, as well as bronchooleural fistula (Fig. <xref rid="313891_1_En_17_Fig45_HTML" ref-type="fig">17.45a, b</xref>).\n).\nFig. 17.45(a, b) HIV/AIDS related Staphylococcus aureus pneumonia. (a) Gross specimen observation demonstrates bilateral purplish brown lesions, patchy white infiltration at the base of the lungs. (b) HE staining demonstrates alveolar diffuse lesions, exudation of the serous fluid and inflammatory cells in the alveolar cavity, and alveolar wall congestion\n'], '313891_1_En_17_Fig64_HTML': ['Aspergillus commonly violates bronchus and lung, with involvements of rhinal sinuses, external auditory canal, eye and skin. Otherwise, it disseminates to organs of the body along with blood flow. The early lesions are diffuse infiltrative and exudative changes. And advanced lesions are necrosis, pyogenesis or granuloma. Large quantity hyphae can be found in the lesions. The hyphae penetrate the blood vessels to cause vasculitis, perivascular inflammation and thrombosis. And thrombosis can cause ischemia and necrosis of the tissue. According to the pathological changes and imaging findings, it can be divided into three major types: vascular invasion type, bronchopneumonia type and allergic bronchopulmonary aspergillosis type. (1) The vascular invasion type is the result caused by toxins released in the process of aspergillus spreading extensively from the primary focus to the lungs. Vascular infiltration of the pulmonary parenchyma and coagulative necrosis are believed to be the cause of vascular occlusion and pulmonary infarction. (2) Bronchopneumonia type is acute bronchitis caused by inhalation of Aspergillus spores. In the cases of hyphae invasion into the lung tissues, extensive infiltrative pneumonia or focal granuloma are resulted in. It can also cause necrosis, pyogenesis and multiple small abscesses. Spherical pulmonary aspergillosis is often secondary to bronchiectasis, tuberculosis, carcinous cavity and other lung diseases. Mycelia multiply and gather in the cavities of the lungs to form a spherical mass with fibrin and mucosal cells, which are called aspergillar glomera, which do not invade the lung tissue. (3) Allergic bronchopulmonary aspergillosis type is the proliferation and germination of inhaled Aspergillus spore in the airway, often showing obvious related mucosal lesions and eventually resulting in bronchiectasis (Fig. <xref rid="313891_1_En_17_Fig64_HTML" ref-type="fig">17.64a–c</xref>).\n).\nFig. 17.64(a) Gross observation demonstrates dark brown lungs in appearance. (b, c) Thology demonstrates hemorrhage and edema of the lung tissue and focal necrosis, with large quantity Aspergillus hyphae and spores in the surrounding area of the necrosis (Combined with pulmonary CMV infection)\n'], '313891_1_En_17_Fig77_HTML': ['In the early stage of cryptococcal infection, only a mild inflammatory reaction or diffuse infiltrative exudative changes occur. But in the advanced stage, necrosis, suppuration or granuloma is formed. Large quantity hyphae can be found in the focus. In the cases with hyphae penetrating the blood vessels, vasculitis, perivascular inflammation and thrombosis occur. And thrombosis leads to ischemia and necrosis of the tissue (Fig. <xref rid="313891_1_En_17_Fig77_HTML" ref-type="fig">17.77</xref>).\n).\nFig. 17.77HE staining demonstrates isseminated cryptococci, the Cryptococcus is stained red after mucin carmine staining of cryptococcus neoformans spores in lungs, (HE\u2009×\u2009200)\n'], '313891_1_En_17_Fig97_HTML': ['Cytomegalovirus pneumonia has extensive pathological changes in the lungs. Pathologically, it shows interstitial pneumonia, with the lesions randomly blood borne distributing in the lungs. The distribution can be diffuse, panlobular or focal. The target cells of pathological changes include alveolar cells and macrophages. Diffused pulmonary interstitial edema and fibrosis as well as alveolar swelling, focal necrosis, bleeding and hyperplasia occur after CMV infections to cause hypoxemia. Gross observation of fresh specimens demonstrates pulmonary surface edema and flaky blooding spots. Fixed specimens demonstrate brown hard lung tissues. Under a microscope, pulmonary interstitial congestion as well as infiltration of lymphocytes and mononuclear cells can be found, with the involved epithelial cells enlarged. In the pulmonary interstitium and alveoli, there are intranuclear inclusions, cytoplasmic inclusions and fluid containing abundant proteins. The classical intranuclear inclusions can be found in the cells, purplish red or purplish blue, round or oval, with surrounding halos in eagle eyes sign. Atypical cytomegalic inclusions in cells are slender, long and round liked with abundant cytoplasm and accentric nucleolus, which are blurry, unclear and atypical (Fig. <xref rid="313891_1_En_17_Fig97_HTML" ref-type="fig">17.97a–e</xref>). Immunohistochemitry demonstrates HIV P24 antigen positive.\n). Immunohistochemitry demonstrates HIV P24 antigen positive.\nFig. 17.97(a) Gross observation of the fresh specimen in autopsy demonstrates pulmonary edema and congestion of cytomegalovirus pneumonia. (b) Gross observation of the formalin fixed specimen in autopsy demonstrates dark brown hard pulmonary tissues. (c, d) HE staining demonstrates large quantity cytomegalovirus inclusions in eagle eyes sign. (e) Immunohistochemical demonstrates HIV P24 antigen positive in macrophages of lung tissues (×400)\n']} | HIV/AIDS Related Respiratory Diseases | [
"HIV/AIDS related pneumocystis carnii pneumonia (PCP)",
"HIV/AIDS related pulmonary bacterial infections",
"HIV/AIDS related pulmonary fungal infections",
"HIV/AIDS related pulmonary virus infections",
"HIV/AIDS related pulmonary parasitic diseases",
"HIV/AIDS related pulmonary neoplasm"
] | None | 1380524400 | None | null | other | PMC7121050 | null | null | [
""
] | Radiology of HIV/AIDS. 2013 Sep 30;:377-535 | NO-CC CODE |
|
(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs | 313891_1_En_17_Fig92b_HTML | 7 | 4613e0bd8bbb013024b2335ae2f7fb1997dab5d93ee1c395c97035d6e7d37750 | 313891_1_En_17_Fig92b_HTML.jpg | multiple | multiple panels: images | [
"Clinical Imaging"
] | [
"computerized tomography"
] | [
782,
247
] | [{'image_id': '313891_1_En_17_Fig115b_HTML', 'image_file_name': '313891_1_En_17_Fig115b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig115b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lung cancer. (a–f) CT scanning demonstrates diffuse soft tissue density shadows in left upper lung, round liked mass shadows in the middle lung field, thickened pleura in the lateral chest wall with adhesion, and strip liked liquid density shadows', 'hash': '37ffef88f4c6dffdd2849b9994419efe1bf8f369ad111d82071f2f004a9fa43f'}, {'image_id': '313891_1_En_17_Fig106a_HTML', 'image_file_name': '313891_1_En_17_Fig106a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig106a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related lymphoma. (a–b) DR demonstrates enlarged and thickened left hilum in a huge mass shadow. High KV demonstrates a huge mass shadow in the hilum. (c–h) CT scanning of the pulmonary window demonstrates a huge high density mass shadow in the left hilum, surrounding nodular fusion shadows in the lung tissues. CT scanning of the mediastinal window demonstrates a huge high density mass shadow in the left hilum, with air bronchogram sign in the shadow', 'hash': '1ff6a74f6517ed666fda8da1eb38cd58b7d92c3687c533350df4caf4cb7ba7d7'}, {'image_id': '313891_1_En_17_Fig67a_HTML', 'image_file_name': '313891_1_En_17_Fig67a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig67a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows. (e–h) Reexamination of the pulmonary window after 3 months treatment demonstrates multiple scattered round liked nodular shadows and thick wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows which obviously increase and enlarge compared to previous lesions, with accompanying infiltration shadows around the lesions', 'hash': '75b2dd5456ce09da0ace0b9787ea5a36d49c80e174314762343564032297b51c'}, {'image_id': '313891_1_En_17_Fig14_HTML', 'image_file_name': '313891_1_En_17_Fig14_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig14_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, mass and flakes of parenchymal shadows in the posterior segment of the right upper lobe and in the dorsal segment of both lower lobes which is more obvious in the right lung, and bronchial shadows in them', 'hash': 'bc4343d2071f380a05855c1e658dc05d90d8ae123e988cfe12c3e65526b3336c'}, {'image_id': '313891_1_En_17_Fig104_HTML', 'image_file_name': '313891_1_En_17_Fig104_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig104_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymphoid interstitial pneumonia. (a–f) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs in reticular appearance, with accompanying multiple small nodular shadows, fusion of some nodules into flaky shadows, and ground glass liked changes in the lung fields', 'hash': '4883f041ed6e05ad0ce9ee6734fea4171aae151209ba36cbce94c8434c86f174'}, {'image_id': '313891_1_En_17_Fig98b_HTML', 'image_file_name': '313891_1_En_17_Fig98b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig98b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates thickened lung markings in both lungs, which extend to the outer zone of the lungs. (b) DR demonstrates thickened and deranged lung markings in both lungs with nodular blurry shadows; and cloudy shadows in lung fields. (c, d) CT scanning demonstrates thickened lung markings in both lungs, with diffuse nodular shadows; and cloudy changes in lung fields. (e) HE staining demonstrates cytomegalovirus inclusions', 'hash': '489286db9d367c09fbc842e4d1ba093d9caa6ded75760e9e1a70e05a86f43979'}, {'image_id': '313891_1_En_17_Fig53_HTML', 'image_file_name': '313891_1_En_17_Fig53_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig53_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) Anteroposterior and lateral DR demonstrates enlarged and thickened left hilum, and large flaky blurry shadows with increased density in the left lower lung. (c, d) Reexamination demonstrates normal lungs after antibiotic treatment', 'hash': 'd9cd861c21f1100d02e20014901c7e4a9a9bcad2e4ddcd3c731b50168d8782be'}, {'image_id': '313891_1_En_17_Fig114b_HTML', 'image_file_name': '313891_1_En_17_Fig114b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig114b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related Kaposi’s sarcoma. (a–d) CT scanning demonstrates scattered cloudy mass and flakes liked or nodular shadows with increased density in both lungs with uneven density and unclear boundaries, fusion and parenchymal changes of some lesions, more lesions in the lower lobe of both lungs and mostly with parenchymal changes. (e, f) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large and thick stained nucleoli, which are in line with the manifestations of Kaposi’s sarcoma. (g, h) Immunohistochemical demonstrates positive of C3 and C4', 'hash': '586be9acfd2434fad0db1a2ffaba9ac72eb8eb799b76acdaeac2730c48c45020'}, {'image_id': '313891_1_En_17_Fig107a_HTML', 'image_file_name': '313891_1_En_17_Fig107a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig107a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related lymphoma. (a–e) CT scanning of the pulmonary and mediastinal windows demonstrates multiple round liked nodular shadows with increased density in both lung fields, with clear boundaries; large soft tissue mass shadows in the right lower lung, with slightly lobulated boundaries and spikes. (f–i) CT scanning of the pulmonary and mediastinal windows for reexamination after radiation therapy demonstrates shrinkage of intrapulmonary nodules and masses', 'hash': '4ca6acd1461c3d7b80869d7d33bd1a3d91ecd1a0dc1b5c7baecc0bfbcf817449'}, {'image_id': '313891_1_En_17_Fig75b_HTML', 'image_file_name': '313891_1_En_17_Fig75b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig75b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval or sphere shaped nodular shadows in the cavities with smooth boundaries. (e, f) Reexamination after treatment demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval nodular shadows in the cavity with smooth boundaries. Compared to the previous imaging findings, the lesions are shrunk, with improved surrounding infiltration', 'hash': 'b1a96158009afcb5e673cf31f9243ca598c763c294bbdc7479a918fb36b031e8'}, {'image_id': '313891_1_En_17_Fig25d_HTML', 'image_file_name': '313891_1_En_17_Fig25d_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25d_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '1e7425ad1ac60b1c612434d02bbe7d48ba0fb82e0642b09b8771b4fea9a7a4c2'}, {'image_id': '313891_1_En_17_Fig66a_HTML', 'image_file_name': '313891_1_En_17_Fig66a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig66a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates large flaky shadows with increased density in the right upper lung, with blurry boundaries; round liked or sphere shaped mass shadows in the right lower lung, with uneven density. (b–e) CT scanning of the pulmonary window demonstrates multiple round liked thick-wall cavities in the dorsal segment of the right lower lung, with small nodular shadow adhering on the cavity wall; and surrounding small nodular shadows and infi ltration shadows. (f, g) Coronal CT scanning reconstruction demonstrates a huge thick-wall cavity in the right upper lung, with irregular thickness of the wall; round liked cavity shadows in the right lower lung, with thick and multilocular walls; and flaky shadows with increased density in the outer zone of the left lower lung', 'hash': 'efec688fc6d0fd9fc9188edcc4a4bb040754e9c9e3261fcacec068f3bfd0252f'}, {'image_id': '313891_1_En_17_Fig63_HTML', 'image_file_name': '313891_1_En_17_Fig63_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig63_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Rhodococcus equi pneumonia. (a) Pulmonary CT scanning demonstrates a mass shadow in the lateral segment of the right middle lobe in size of 4.7\u2009×\u20093.7\u2009×\u20093.2 cm with uneven density and lace liked boundary, and small bubbles shadows in it. By both sputum culture and lung tissue culture, Rhodococcus equi can be detected. (b, c) Pathological biopsy and HE staining demonstrate inflammatory pseudotumor. (d, e) Immunohistochemistry demonstrates Rhodococcus equi antibody positive. (f) Reexamination after treatment demonstrates obvious shrinkage of the original lung lesions', 'hash': 'ac97b316499d751a48d8b861962da376a39c7ff11d2554ed957c226224dc65b6'}, {'image_id': '313891_1_En_17_Fig2a_HTML', 'image_file_name': '313891_1_En_17_Fig2a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig2a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered miliary increased density shadows in both lungs, with even size, density and distribution. The shadows of both hila are dense, with sharp both costophrenic angles. (b–f) CT scanning demonstrates scattered miliary nodular shadows in both lungs, which is more obviously in the middle pulmonary strip and with quite even size and density. Trachea and bronchi are unblocked', 'hash': 'ec4f2f75b5bb59b2cb13f016c2ea6714bdc3c908077c2697af2218aa485876b7'}, {'image_id': '313891_1_En_17_Fig13a_HTML', 'image_file_name': '313891_1_En_17_Fig13a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig13a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, transparent areas in them and unblocked trachea and bronchi', 'hash': '7d26c2f94a34f3ff7c4f64d485fe29e114936d0f4db53489ee88148a1a6fc8bf'}, {'image_id': '313891_1_En_17_Fig65a_HTML', 'image_file_name': '313891_1_En_17_Fig65a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig65a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related allergic pulmonary Aspergillus infection. (a–f) CT scanning of the pulmonary window demonstrates thickened central pulmonary markings in both lungs, which is turtuous and deranged with fingertip infiltration shadows. (g) DR demonstrates hyperinflation of the right lung, increased and thickened pulmonary markings and ground glass liked shadows with increased density in the right lower lung and left lung lobe', 'hash': '6fa5ade163d7465c0dc3eb89ebc58d57b98674fc2680824cc5a81c478b81fbc4'}, {'image_id': '313891_1_En_17_Fig76b_HTML', 'image_file_name': '313891_1_En_17_Fig76b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig76b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning demonstrates diffuse scattered thin ground glass liked, patchy, flaky blurry shadows and cords liked shadows in both lungs, with blurry boundaries and uneven density; scattered nodular shadows in different sizes; more lesions in both upper lobes and the right middle lobe; flaky parenchyma shadows in the apical and posterior segments of right upper lobe, with air bronchogram sign in them; unobstructed opening of bronchi as well as lobar and segmental bronchi without stenosis and obstruction; lymphadenectasis in the right hilar region; detected Aspergillus fumigatus by sputum culture. (e, f) Culture for 72 h, lactic acid gossypol blue staining and microscopic observation at ×200 and ×400 demonstrate short column liked conidial head, smooth wall of conidiophores, flask-shaped top capsule and monolayer microconidiophores. (g) Culture in Paul’s medium demonstrates dark green colored colonies', 'hash': 'af925cb00cbd4eed9e67dc49fd012909ecdfe48493ac645d8b2185eb4f351655'}, {'image_id': '313891_1_En_17_Fig105a_HTML', 'image_file_name': '313891_1_En_17_Fig105a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig105a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary toxoplasmosis. (a–d) CT scanning demonstrates thickened pulmonary markings in both lungs, which can be enhanced to extend into the middle and outer zones of lungs, in grid liked appearance that is more obvious in the dorsal segment of the lungs. (e) It is demonstrated to have clustering toxoplasma tachyzoites', 'hash': '30f16a35256e45c89dfcd68adf661507960a5b978db88cc531a7605d9fff53df'}, {'image_id': '313891_1_En_17_Fig95_HTML', 'image_file_name': '313891_1_En_17_Fig95_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig95_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a) CT scanning of the pulmonary window demonstrates irregular large flaky shadows with increased density in the dorsal segment of both lower lobes; enlarged hilum in both lungs, cords liked thickening of the vascular vessels. (b) CT scanning of the mediastinal window demonstrates flaky parenchyma shadows in the left lower lung, thickening of both pleura, enlarged hilum shadows in both lungs, thickened right lower bronchial wall. (c) Microscopy after culture at 25 °C demonstrates branches and separated hyphae and its string of small spores, with typical penicillus but no sporangium (Medan staining, ×400). (d) Bone marrow smear demonstrates round or oval cells like the yeast phase within the macrophages; longer cells like the yeast phase outside the macrophages. The two kinds of cells have slightly curved ends in sausages liked appearance (HE staining, ×400)', 'hash': '636de07e02ba7cf1f73f2a03bccf4fdaac68bc4a122b7fbfe2febe72dd42f139'}, {'image_id': '313891_1_En_17_Fig3a_HTML', 'image_file_name': '313891_1_En_17_Fig3a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig3a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy and scattered miliary increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of the lower lung field, with some fused in thin cloudy shadows', 'hash': 'e655c40874d38beaa8a8e9f0e82c1eb12a6756b09bee559229354b3756010a18'}, {'image_id': '313891_1_En_17_Fig73_HTML', 'image_file_name': '313891_1_En_17_Fig73_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig73_HTML.jpg', 'caption': '(a–c) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates diffuse dense shadows in both lower lung fields which is in a arcuate surface with exterior high and interior low (pleural effusion). (b, c) CT scanning of the mediastinal window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavities; thickened pleura of the lateral chest wall, with accompanying encapsulated effusion', 'hash': '9ad36ea5213bea731770658b27be87e1af9e34bced02cda664a7f485e40f2315'}, {'image_id': '313891_1_En_17_Fig54_HTML', 'image_file_name': '313891_1_En_17_Fig54_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig54_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates round liked large flaky shadows with increased density in the left lower lung, enlarged and thickened hilus. (c, d) DR reexamination after treatment demonstrates flocculent shadows in the left lower lung, with improved conditions than previous findings before treatment (a, b)', 'hash': 'f9b4f22920ef55d9110380df6f64a6a508ecea9ca3192877a2d47400e781c58d'}, {'image_id': '313891_1_En_17_Fig58b_HTML', 'image_file_name': '313891_1_En_17_Fig58b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig58b_HTML.jpg', 'caption': '(a–i) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) CT scanning of the pulmonary window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (c, d) CT scanning of the mediastinal window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, pulmonary atelectasis and pleural effusion, with ventilation shadows in them. (e) CT scanning of the pulmonary window after the treatment demonstrates absence of the mass shadows in the left lower lung with transverse stripes shadows, obviously improved than previous findings (a, b). (f) HE staining demonstrates thickened alveolar septa and exudates from the alveolar cavity. (g) HE staining demonstrates massive bleeding in the alveolar cavity, large quantity erythrocytes and intact cell walls. (h) HE staining demonstrates phagocytized basophilic granules in the leukocytes. (i) HP staining demonstrates purplish red Rhodococcus equi in a shape of crescent in orange red sputum', 'hash': 'ca8456a79f660fc4faa5eb9342f84a14bbe25eedd8fb237ac65bd96b8de6e5b9'}, {'image_id': '313891_1_En_17_Fig25c_HTML', 'image_file_name': '313891_1_En_17_Fig25c_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25c_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '64e0ceda545f1684d11c717eef852c6576036d711540954850cc018aadfefa87'}, {'image_id': '313891_1_En_17_Fig44_HTML', 'image_file_name': '313891_1_En_17_Fig44_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig44_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary nontuberculous mycobacterial infection. (a–d) CT scanning demonstrates multiple cavities in the left lung field, bilateral multiple lobular central nodules and extensive branches liked linear shadows in tree buds sign. There are also large flaky parenchymal changes of the lung tissues in the left lower lung field in high density shadows, with accompanying air bronchogram sign. (e) HE staining demonstrates avium intracellular complex mycobacteria infection of lung tissues in atypical tuberculous nodular changes. (HE\u2009×\u2009200)', 'hash': '8f8697761c60c3cb27c0b413c2e19433df26ba07a74ea0a0cc0b6f2b4acc7b65'}, {'image_id': '313891_1_En_17_Fig103_HTML', 'image_file_name': '313891_1_En_17_Fig103_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig103_HTML.jpg', 'caption': '(a–d) HIV/AIDS related lymphoid interstitial pneumonia. (a–d) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs, in reticular appearance; with accompanying multiple small nodular shadows', 'hash': '8d52c3bac6fb07e3eaf12386767e159f762db3072e09365be542c937697babe7'}, {'image_id': '313891_1_En_17_Fig110b_HTML', 'image_file_name': '313891_1_En_17_Fig110b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110b_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '5526a48dae3face516d842ba229b164bac3062f56c5e811bb1e725778fd20823'}, {'image_id': '313891_1_En_17_Fig5a_HTML', 'image_file_name': '313891_1_En_17_Fig5a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig5a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates patchy shadows with increased density in both lungs, with thickened hilar shadows in both lungs. (b–g) CT scanning demonstrates flaky ground glass liked density shadows in upper lungs and dorsal segment of both lungs, which is more obvious in the middle inner strips. There are extrapulmonary stripes transparent shadows, with some bronchial walls thickened and enlarged hilar shadows in both lungs', 'hash': '5d6ab0400e0331b0fcb3a3679023a44fa81b7b9c9eedc00c0ddb6d85208c3512'}, {'image_id': '313891_1_En_17_Fig74_HTML', 'image_file_name': '313891_1_En_17_Fig74_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig74_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates round liked uneven density shadows in the medial segments of both middle and lower lungs, multilocular hollow holes in the cavities, surrounding multiple round liked thick-wall small cavity shadows and ground grass liked infiltration shadows. (b–d) CT scanning of the pulmonary window demonstrates scattered round liked uneven density shadows in the right hilum and lower lung, multilocular hollow holes in the cavities; and surrounding multiple round liked thick-wall small cavity shadows and ground grass liked infiltration shadows', 'hash': 'e4c42cc0cb1f1bdfa8b2cc1f3c8eab7223c4be368a808e8b6c4b01af78dfb04a'}, {'image_id': '313891_1_En_17_Fig23_HTML', 'image_file_name': '313891_1_En_17_Fig23_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig23_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymph node tuberculosis. (a–c) CT scanning of the pulmonary window demonstrates dense mass shadow beside the right aortic arch, and thinner right bronchus due to compression. (d–f) CT scanning of the mediastinal window demonstrates low density mass shadow besied the right aortic arch with clear boundary', 'hash': '8d135ce7e96005006343dc3305be0f8c77d0828bccccf1726226c09fd47c365f'}, {'image_id': '313891_1_En_17_Fig6a_HTML', 'image_file_name': '313891_1_En_17_Fig6a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig6a_HTML.jpg', 'caption': '(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe', 'hash': '235548456c9bf72727a05a91fa6893d8a478f8f715c022d6b579d4a9188da366'}, {'image_id': '313891_1_En_17_Fig17a_HTML', 'image_file_name': '313891_1_En_17_Fig17a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig17a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchymal shadows and fibrous cords liked shadows in both lungs which are more obvious in both lower lungs. The trachea and bronchi are unblocked, with enlarged hilar shadows in both lungs', 'hash': '9c1c59095291dcf6a7b6dec786ec58ba44e9b83badfe4bbf121b7c677476f4d5'}, {'image_id': '313891_1_En_17_Fig113b_HTML', 'image_file_name': '313891_1_En_17_Fig113b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig113b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Kaposi’s sarcoma. (a–d) Chest CT scanning demonstrates scattered cloudy, mass and flake liked or nodular shadows with increased density. (e) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large thick stained nucleoli, which are in line with the diagnosis of Kaposi’s sarcoma. (f–i) Cured HIV/AIDS related Kaposi’s sarcoma. (f–i) Reexamination after treatment demonstrates absent lesions in both lungs, with clear lung fields', 'hash': '88e574b2d5ff4ee4ce28f38025d5345c8cf6b50386f752ae12083b05fe7af9de'}, {'image_id': '313891_1_En_17_Fig82_HTML', 'image_file_name': '313891_1_En_17_Fig82_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig82_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a, b) DR demonstrates enlarged blurry hilum in both lungs and thickened pulmonary markings. (c, d) CT scanning demonstrates mediastinal lymphadenectasis, narrowed trachea due to compression with liquefactive necrosis. Enhanced scanning demonstrates marginal enhancement and no central enhancement', 'hash': '18312183daaefbc6c48e05e67fab210a1109c24a6f94311ffb11ffdace007a49'}, {'image_id': '313891_1_En_17_Fig64_HTML', 'image_file_name': '313891_1_En_17_Fig64_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig64_HTML.jpg', 'caption': '(a) Gross observation demonstrates dark brown lungs in appearance. (b, c) Thology demonstrates hemorrhage and edema of the lung tissue and focal necrosis, with large quantity Aspergillus hyphae and spores in the surrounding area of the necrosis (Combined with pulmonary CMV infection)', 'hash': '104850f2999da711317f4e4f07e590bd8f73a93731daf090ece6023192606e90'}, {'image_id': '313891_1_En_17_Fig7a_HTML', 'image_file_name': '313891_1_En_17_Fig7a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig7a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates diffusely distributed shadows with increased density in both lungs that is more obvious in the middle and lower lungs. The hilar shadows in both lungs are enlarged. Both diaphragmatic surfaces and phrenic angles are blurry. (b–d) CT scanning demonstrates flaky shadows with increased density in both lungs, with parenchymal shadows in the lingular segment of left upper lobe and in the dorsal segments of both lower lobes and bronchial shadows in them. There are also thickened bronchial walls and enlarged hilar shadows in both lungs', 'hash': '431aab0770a1915c719095cc2bab91736f1ffda7b5649cdca5d8b7516003049c'}, {'image_id': '313891_1_En_17_Fig33_HTML', 'image_file_name': '313891_1_En_17_Fig33_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig33_HTML.jpg', 'caption': '(a, b) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates scattering patchy and cords liked blurry density shadows in the right middle and upper lung fields as well as enlarged and thickened hilum. (b) DR demonstrates that the lungs lesions are almost absent compared to (a), after anti-TB treatment for 5 months', 'hash': 'e710598bbbc8286721136f2a803716198a712c55253c4232d3ee33b2e33e188b'}, {'image_id': '313891_1_En_17_Fig62_HTML', 'image_file_name': '313891_1_En_17_Fig62_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig62_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) Anteroposterior and lateral DR demonstrates huge sphere liked mass shadow in the right hilum, with cavities shadows and liquid gas level in it. (c) HE staining demonstrates bleeding in the lung tissues and aggregation of large quantity lymphocytes. (d) Masson staining demonstrates branches liked purplish red Rhodococcus equi', 'hash': '261a4aca9e146cc16957c6280cd4795d7c2c5732d9a19006b6e398a1ae410af0'}, {'image_id': '313891_1_En_17_Fig84_HTML', 'image_file_name': '313891_1_En_17_Fig84_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig84_HTML.jpg', 'caption': '(a, b) HIV/AIDS related pulmonary cryptococcus infection. (a) CT scanning demonstrates round liked cavity shadows in the left upper and lower lung, with uneven thickness of the cavity wall and surrounding infiltrative shadows. (b) CT scanning demonstrates round liked dense mass shadows in the right upper lung, with clear boundaries and bulky drainage vessel shadows', 'hash': 'ecc614167ec536dcb80c2739886c957ff2f182dd49ac7f4d6379260497262e60'}, {'image_id': '313891_1_En_17_Fig4_HTML', 'image_file_name': '313891_1_En_17_Fig4_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig4_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy or ground glass liked increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of lower lungs, with some fused into thin cloudy ground glass liked shadows with increased density, with decreased transparency of both lungs and enlarged hilar shadows in both lungs', 'hash': '636f9fd3d3c20c17e15e1ac70adcdcb6fbe268a70ac64d29317f73045747e226'}, {'image_id': '313891_1_En_17_Fig46a_HTML', 'image_file_name': '313891_1_En_17_Fig46a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig46a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates large flaky dense shadows in the middle-outer zone of the left middle lung field, and narrowed left bronchus. (d–f) CT scanning demonstrates large flaky shadows with uneven density in the left lateral chest wall and even lower density shadow in them', 'hash': 'afdfc2c33070f1d3b8616a542d989e0f908d9638327227057dfdf5ed59169359'}, {'image_id': '313891_1_En_17_Fig72_HTML', 'image_file_name': '313891_1_En_17_Fig72_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig72_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and cavity shadows in both lungs, with even wall thickness and small nodular shadows in some cavities', 'hash': 'd318b47b9b56854b6bc47081b08712ee9d828a2ae4592aa69451ec7105fd0240'}, {'image_id': '313891_1_En_17_Fig91b_HTML', 'image_file_name': '313891_1_En_17_Fig91b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig91b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–e) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of some lesions into honeycomb likes cavity shadows or plaque liked dense shadows. (f–h) CT scanning demonstrates large thick-wall cavity shadows in the right lung, surrounding plaque and round liked small cavity shadows and inflammatory infiltrative shadows', 'hash': '6b3a934b89abf6f7e8c9593337c0c57fe44161bcbfc546c7e2a3cfa50539f91e'}, {'image_id': '313891_1_En_17_Fig8a_HTML', 'image_file_name': '313891_1_En_17_Fig8a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig8a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates large flaky parenchyma shadows in both lungs which is more obvious in the middle and lower lobes of both lungs. There are also enlarged hilar shadows in both lungs and sharp both costophrenic angles. (b–g) CT scanning demonstrates large flaky parenchyma shadows in concentric and symmetrical distribution, bronchial shadows in them and thickened bronchial walls', 'hash': '7c4f2f4f9120af70727cab6fc69637733e17e807575648a0257b5b03367da625'}, {'image_id': '313891_1_En_17_Fig42_HTML', 'image_file_name': '313891_1_En_17_Fig42_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig42_HTML.jpg', 'caption': 'HIV/AIDS related tuberculous pleuritis. DR demonstrates arch shaped dense shadows with higher exterior density and lower interior density in the left lower lung field and covered right edge of the heart', 'hash': 'f0dfdb1b349a42c7092daeeaef76a8b8762e134b40ae21a6144d9785b9ddcd02'}, {'image_id': '313891_1_En_17_Fig15_HTML', 'image_file_name': '313891_1_En_17_Fig15_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig15_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy blurry shadows and fibrous cords liked shadows in both lungs which are more obvious in the middle inner parts of both lungs, with transparent areas in them. The bronchial walls are thickened', 'hash': '4d262b5c06f74783c1b6df1f8c9d8c7ecbf235faacd2f2e846544a3e11d88e8b'}, {'image_id': '313891_1_En_17_Fig92b_HTML', 'image_file_name': '313891_1_En_17_Fig92b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig92b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs', 'hash': '4613e0bd8bbb013024b2335ae2f7fb1997dab5d93ee1c395c97035d6e7d37750'}, {'image_id': '313891_1_En_17_Fig52_HTML', 'image_file_name': '313891_1_En_17_Fig52_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig52_HTML.jpg', 'caption': '(a, b) HIV/AIDS related staphylococcus aureus pneumonia. (a, b) DR demonstrates diffuse scattered multiple thin-walled transparent areas in both lungs, increased and blurry pulmonary markings, and enlarged heart shadow in flask shape (pericardial effusion)', 'hash': 'b54d395f8405b646839c68cb58c1a811c70fb8c7337443d24b61bfcfa097f5b0'}, {'image_id': '313891_1_En_17_Fig56b_HTML', 'image_file_name': '313891_1_En_17_Fig56b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig56b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates huge round large flaky shadows with increased density in the left lower lung, enlarged and thickened hilum and covered right heart edge. (c, d) DR reexamination after treatment for 1 week demonstrates flocculent shadow in the left lower lung, improved than those before the treatment (a, b). (e) DR reexamination after treatment demonstrates flocculent liked shadows in the left lower lung, obviously improved than before the treatment (c, d)', 'hash': 'e5f534ed9282980e95aaa6bac04091762128cf3e5c46985b190278c5d6396558'}, {'image_id': '313891_1_En_17_Fig93b_HTML', 'image_file_name': '313891_1_En_17_Fig93b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig93b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates diffuse small cavity in honeycomb liked and infiltrative parenchyma shadows, with the hilum as the center to distribute bilaterally symmetric like butterfly wings; multiple honeycomb liked cavity shadows in both lungs. (e–h) CT scanning reexamination demonstrates large irregular thick-wall cavities in the right lung, surrounding scattering nodular, honeycomba liked and infiltrative shadows after anti-PM infection treatment for 3 months', 'hash': '904e5a590c601ab02150f8c2487bbfa6f0282c1eddd547624ce8c549472221d9'}, {'image_id': '313891_1_En_17_Fig51b_HTML', 'image_file_name': '313891_1_En_17_Fig51b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig51b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related staphylococcus aureus pneumonia. (a) Chest X-ray demonstrates large flaky high density shadow in the left middle-lower lung field, with central transparent areas in different sizes and blurry boundaries; parenchyma changes of the left lower lung, predominantly in the posterior and exterior basal segments; unobstructed brounchus and thickened adjacent pleura. (b–d) CT scanning demonstrates large flaky shadows in fan shaped distribution along the bronchus in the left middle-lower lung, with gas containing cavities and high density shadows; and thickened adjacent pleura of the lateral chest wall. (e, f) CT scanning of the mediastinal window demonstrates large flaky fan shaped parenchymal shadows in the left middle-lower lung field, with ventilation shadows in them; and thickened pleura of the lateral chest wall. (g, h) Pathological examination showed staphylococcus aureus', 'hash': '18a6e1202b7b8c4a2d57fe024b7e8039a6dcee0f6f5f078b109a93850977c0f6'}, {'image_id': '313891_1_En_17_Fig94b_HTML', 'image_file_name': '313891_1_En_17_Fig94b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig94b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a–f) CT scanning demonstrates multiple nodules and small cavities in honeycomb liked shadows and infiltrative parenchyma shadows in the right lung; flaky transparent areas (bullae of lung) in the right anterior margin of the heart and in the outer zone of the left lung near lateral chest wall', 'hash': '3ed719abaaaec4ee19332842bd8dcac302eb6fefc73152dfd03a39702260d369'}, {'image_id': '313891_1_En_17_Fig34a_HTML', 'image_file_name': '313891_1_En_17_Fig34a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig34a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung and multiple satellite lesions scattering around. (c) CT scanning of the mediastinal window demonstrates lymphadenectasis of aortic window, subcutaneous soft tissue mass shadow in the left anterior chest wall with central low density shadow as well as right axilliary lymphadenectasis', 'hash': 'dabd5722ad3f66eee67ca59ba24417ffb086d4591f3bff2446f2a3490c676e78'}, {'image_id': '313891_1_En_17_Fig22_HTML', 'image_file_name': '313891_1_En_17_Fig22_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig22_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates semicircular mass liked dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura of lateral chest wall, and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates narrowed right thorax, thickend pleura of lateral chest wall with encapsulated effusion, uneven density mass in the right hilum, thinner right bronchus due to compression and no obvious abnormalities in the left hilum. (f) DR in Aug. 2008 demonstrates no obvious changes of the lesions after anti-tuberculosis treatment for 1 month', 'hash': '8f3d47e32ff0f306eed49c4101730b02a154f676752c7bb56423c767388d5b82'}, {'image_id': '313891_1_En_17_Fig27b_HTML', 'image_file_name': '313891_1_En_17_Fig27b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig27b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related miliary tuberculosis. (a–b) Anteroposterior and lateral DR demonstrates diffuse miliary shadows in both lungs, which are bilaterally symmetric and in even size and distribution. (c–f) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': 'e272956e522e945d068939f056c637c5a636df520c687deeac9d40f8cb06834e'}, {'image_id': '313891_1_En_17_Fig83_HTML', 'image_file_name': '313891_1_En_17_Fig83_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig83_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates enlarged blurry hilum in both lungs and thickened lung markings. (b–d) CT scanning demonstrates multiple scattered nodular or mass dense shadows in both lungs, with lobulation, rough spikes around and fusion of some shadows into mass; surrounding small flaky infiltrative shadows; and mediastinal lymphadenectasis', 'hash': '6b17ec5d2db4d953c2436bbec29d0a3b1dacf0910df899eaf97e442c4aaad785'}, {'image_id': '313891_1_En_17_Fig43a_HTML', 'image_file_name': '313891_1_En_17_Fig43a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig43a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related tuberculous pleuritis. (a) DR demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (b) CT scanning of the pulmonary window demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (c) CT scanning of the mediastinal window demonstrates encapsulated fluid density shadow in the pleura of the right lateral chest wall', 'hash': 'ac09c8d3e5e4d73b07cd258411b07337ad06b99883f4a0e4573ce220fc1f4574'}, {'image_id': '313891_1_En_17_Fig35a_HTML', 'image_file_name': '313891_1_En_17_Fig35a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig35a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates diffuse large flaky dense shadows in the right upper lung with transparent areas in them. (b–c) CT scanning of the pulmonary window demonstrates large flaky shadows with increased density in the right upper lung, with multiple satellite lesions scattering around. (d, e) CT scanning of the mediastinal window demonstrates large flaky parenchymal shadows in the right upper lung with air bronchogram sign as well as mediastinal lymphadenectasis', 'hash': 'f556b77354da8136691c411ed446865babea0e399d96d2fca89f49639a04c579'}, {'image_id': '313891_1_En_17_Fig26b_HTML', 'image_file_name': '313891_1_En_17_Fig26b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig26b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '1d1f0589c50a11306fce77c217b0a9ac31be645df14f41d021ccf6522873dc6c'}, {'image_id': '313891_1_En_17_Fig32_HTML', 'image_file_name': '313891_1_En_17_Fig32_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig32_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstratesdiffuse scattering miliary shadows with increased density in both lungs, fusion of some military shadows into patchy or mass liked shadows and diffusely distributed lung lesions', 'hash': '7274d90d4f9483c5fb0e44576eeb46beba54850ed218057b6ca5935c31fa396a'}, {'image_id': '313891_1_En_17_Fig96b_HTML', 'image_file_name': '313891_1_En_17_Fig96b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig96b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a) DR demonstrates flaky blurry dense shadows in the right anterior margin of the heart, with surrounding infiltrative shadows. (b, c) CT scanning of the pulmonary window demonstrates nodular dense shadows in the dorsal segment of the right lower lung, with smooth sharp boundaries; large flaky ground glass liked dense shadows in the dorsal segment of both lungs. (d, e) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in red, in different sizes. (f) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in purplish red, in different sizes', 'hash': 'ad87dabd309e8a0c47d5cd58aa485a538556b1218d18c3cb262dc5b8cd5049e9'}, {'image_id': '313891_1_En_17_Fig55_HTML', 'image_file_name': '313891_1_En_17_Fig55_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig55_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates round liked large flaky shadows with increased density in the right lower lung, cords liked and flocculent liked blurry shadows in both middle-upper lung fields and in the right lower lung field, and enlarged and thickened hilus', 'hash': '29c690f04a28629d1c3b0f7b5665833edd78ec61be199fd2f16199400a7c9eeb'}, {'image_id': '313891_1_En_17_Fig85a_HTML', 'image_file_name': '313891_1_En_17_Fig85a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig85a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates round liked thick-wall cavity in the left hilum, with blurred boundary; ground-glass liked shadows with increased density in the left middle and lower lung. (b–d) CT scanning of the pulmonary window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of cavity wall. (e, f) CT scanning of the mediastinal window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of the cavity wall and surrounding thick spikes', 'hash': 'd6bc5b1be05729f5f4ec60a0cda3bec7f7cf437fd39e0d32743e45cfb9e48de2'}, {'image_id': '313891_1_En_17_Fig112_HTML', 'image_file_name': '313891_1_En_17_Fig112_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig112_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Kaposi’s sarcoma. (a, b) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance', 'hash': 'eeb255e4963802d02da7fd85381532153336be33b21e4ceb488be5dc2a483f29'}, {'image_id': '313891_1_En_17_Fig25b_HTML', 'image_file_name': '313891_1_En_17_Fig25b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25b_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '9ceac8f407a9896d7bda0165bceae81a32d5c5c53de3c5d2a295c165b15071e8'}, {'image_id': '313891_1_En_17_Fig36a_HTML', 'image_file_name': '313891_1_En_17_Fig36a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig36a_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) Pulmonary CT scanning of the pulmonary window demonstrates parenchymal shadows in the left lingual lobe with surrounding pulmonary acinar nodular shadows. (b) CT guided pucture biopsy of left lingula. (c) The pathology demonstrates granulation tissue and caseous necrosis, being in consistency with tuberculosis changes. HE\u2009×\u2009100', 'hash': '3a48cc084a1fb1943e1411fa65cfdcee0c3c33377b3ae6ab6e24f04ee1caebae'}, {'image_id': '313891_1_En_17_Fig68a_HTML', 'image_file_name': '313891_1_En_17_Fig68a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig68a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in prone posture demonstrates mass shadow and thick wall cavity in the dorsal segment of the right lower lung, small nodular shadows in the cavities, surrounding fused miliary infiltration shadows. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the dorsal segment of the right lower lung, small nodular shadows in the cavities, and involved pleura of partial lateral chest wall', 'hash': '0acc77833f25b70e7e4527a30be9fc6744e19cee48879415a15e648d76923d48'}, {'image_id': '313891_1_En_17_Fig45_HTML', 'image_file_name': '313891_1_En_17_Fig45_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig45_HTML.jpg', 'caption': '(a, b) HIV/AIDS related Staphylococcus aureus pneumonia. (a) Gross specimen observation demonstrates bilateral purplish brown lesions, patchy white infiltration at the base of the lungs. (b) HE staining demonstrates alveolar diffuse lesions, exudation of the serous fluid and inflammatory cells in the alveolar cavity, and alveolar wall congestion', 'hash': 'e530a1df1ead29989d8b3b50161f1926946446bc5cbbcb99691479816876e341'}, {'image_id': '313891_1_En_17_Fig110c_HTML', 'image_file_name': '313891_1_En_17_Fig110c_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110c_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '22d9f8a4fa731c46a738334c9738c267aaa2c43711aa94bd98c4b78483adda8d'}, {'image_id': '313891_1_En_17_Fig24b_HTML', 'image_file_name': '313891_1_En_17_Fig24b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig24b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates circular mass dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura in the lateral chest cavity and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates multiple uneven mass density shadows in right hilum in a size of about 3\u2009×\u20093.5\u2009×\u20093.8 cm. (f–g) Enhanced CT scanning demonstrates slight uneven enhancement of the lesion and no obvious abnormalties in the left hilum', 'hash': '4c7c3a8f7b0bde1c89efcf634beedfd08159b9be03a95299448e388c435edcdc'}, {'image_id': '313891_1_En_17_Fig12_HTML', 'image_file_name': '313891_1_En_17_Fig12_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig12_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchyma shadows and fibrous cords liked shadows in both lungs which are more obvious in the dorsal segment of both lower lungs, bronchial shadows in them, and thickened bronchial walls in the middle lobe. The hilar shadows in both lungs are enlarged', 'hash': '72a066b603a93a4b8e9a7a8ec1942b2ed87b211dee6ed121b7c56d1cb575c55c'}, {'image_id': '313891_1_En_17_Fig102_HTML', 'image_file_name': '313891_1_En_17_Fig102_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig102_HTML.jpg', 'caption': '(a–d) HIV/AIDS related lymphoid interstitial pneumonia. (a–d) CT scanning demonstrates thickened and deranged pulmonary markings in both lungs, in reticular appearance; with accompanying multiple small nodular shadows', 'hash': '6b569d4d7a5a4f008ea8f7bc4152cd1a576656b8eeee8b7548f00de038815256'}, {'image_id': '313891_1_En_17_Fig111_HTML', 'image_file_name': '313891_1_En_17_Fig111_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig111_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Kaposi’s sarcoma. (a, b) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance, light density flaky shadows in lower lung fields of both lungs. (c) CT scanning demonstrates multiple round liked nodular shadows in both middle lower lung fields with clear boundaries, multiple mediastinal and hilar lymphadenectasis, and small quantity pleural effusion in bilateral thoracic cavities', 'hash': '5dfb9d581ecc41659920bde84bc55d01903bf9f66ec50710fe0465373096ff5f'}, {'image_id': '313891_1_En_17_Fig25a_HTML', 'image_file_name': '313891_1_En_17_Fig25a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig25a_HTML.jpg', 'caption': '(a–m) HIV/AIDS related lymph node tuberculosis. (a–f) MR imaging demonstrates multiple round liked long T1WI long T2WI signal adjacent to the right sternocleidomastoid as well as in the supraclavicular fossa and the right upper mediastinum. (g–j) Sagittal MR imaging demonstrates multiple round liked sugar-coated haws liked masses in the entrance of the thorax and right upper mediastinum, with central long T1WI signal and unclear boundary. (k, l) Axial MR imaging demonstrates round liked long T1WI long T2WI signal in the right cardiophrenic angle (arrow). (m) Coronal MR imaging demonstrates round liked equal signal shadow', 'hash': '67db71f0f56d65c929e36f486b4a1a2246ae852aec999328f126ddc09428f814'}, {'image_id': '313891_1_En_17_Fig36b_HTML', 'image_file_name': '313891_1_En_17_Fig36b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig36b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) Pulmonary CT scanning of the pulmonary window demonstrates parenchymal shadows in the left lingual lobe with surrounding pulmonary acinar nodular shadows. (b) CT guided pucture biopsy of left lingula. (c) The pathology demonstrates granulation tissue and caseous necrosis, being in consistency with tuberculosis changes. HE\u2009×\u2009100', 'hash': 'd7d5abe0c9d9bea2e2097dfc72f86922656058f98f8a2360573b04a02e27e5de'}, {'image_id': '313891_1_En_17_Fig68b_HTML', 'image_file_name': '313891_1_En_17_Fig68b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig68b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in prone posture demonstrates mass shadow and thick wall cavity in the dorsal segment of the right lower lung, small nodular shadows in the cavities, surrounding fused miliary infiltration shadows. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the dorsal segment of the right lower lung, small nodular shadows in the cavities, and involved pleura of partial lateral chest wall', 'hash': 'cada0e4684021c74f9b0d4d1bcdb6810379bc035cead748d6de141ebd004f038'}, {'image_id': '313891_1_En_17_Fig96a_HTML', 'image_file_name': '313891_1_En_17_Fig96a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig96a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a) DR demonstrates flaky blurry dense shadows in the right anterior margin of the heart, with surrounding infiltrative shadows. (b, c) CT scanning of the pulmonary window demonstrates nodular dense shadows in the dorsal segment of the right lower lung, with smooth sharp boundaries; large flaky ground glass liked dense shadows in the dorsal segment of both lungs. (d, e) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in red, in different sizes. (f) HE staining demonstrates spores and round liked, long circular or sausage shaped corpuscles in purplish red, in different sizes', 'hash': '020553d48c8545e50d314020ad8dc5004914dca5449aa2b58bc99515f310c3a4'}, {'image_id': '313891_1_En_17_Fig85b_HTML', 'image_file_name': '313891_1_En_17_Fig85b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig85b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates round liked thick-wall cavity in the left hilum, with blurred boundary; ground-glass liked shadows with increased density in the left middle and lower lung. (b–d) CT scanning of the pulmonary window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of cavity wall. (e, f) CT scanning of the mediastinal window demonstrates thick-wall cavity in the dorsal segment of the left lower lung, with uneven thickness of the cavity wall and surrounding thick spikes', 'hash': '9778eb0d00755e3cd06bd3bcee90d66970730aac4b7fabde0b3e1df25cc067b8'}, {'image_id': '313891_1_En_17_Fig59_HTML', 'image_file_name': '313891_1_En_17_Fig59_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig59_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a–c) CT scanning of the pulmonary window demonstrates thick walled cavities shadows in the dorsal segment of the right lower lung, with irregular wall thickness and liquid gas level in them. (d) CT scanning of the mediastinal window demonstrates thick walled cavities shadows in the dorsal segment of the left lower lung, with irregular wall thickness and liquid gas level in them', 'hash': 'c9ff1150b9c2d245c823a3726a56dc22223fcdc58b24666ee55ee0b01ea0c2d3'}, {'image_id': '313891_1_En_17_Fig24a_HTML', 'image_file_name': '313891_1_En_17_Fig24a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig24a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates circular mass dense shadow in the right hilum that protrudes to the lung field with peripheral thickened and blurry pulmonary markings, thickened pleura in the lateral chest cavity and blunt costophrenic angle in Jan. 2008. (b–e) CT scanning demonstrates multiple uneven mass density shadows in right hilum in a size of about 3\u2009×\u20093.5\u2009×\u20093.8 cm. (f–g) Enhanced CT scanning demonstrates slight uneven enhancement of the lesion and no obvious abnormalties in the left hilum', 'hash': 'a3536c779e7c502b855dd3d89ae13854f569bd483ba8038870ac76c68c616c6c'}, {'image_id': '313891_1_En_17_Fig11_HTML', 'image_file_name': '313891_1_En_17_Fig11_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig11_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered patchy shadows with increased density in both lungs and a few cords liked shadows which are more obvious in the right lung. There are thickened both hilar shadows and sharp both costophrenic angles. (b–e) CT scanning demonstrates flaky and mass liked ground glass density shadows in both lungs and a few cords liked shadows which are more obvious in the right lung. The trachea and bronchi are unblocked', 'hash': 'd4448bd9682d4ae721b1250cec042eecf77787519b1af61ac3b2d7b88b28bd90'}, {'image_id': '313891_1_En_17_Fig101_HTML', 'image_file_name': '313891_1_En_17_Fig101_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig101_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Herpes Simplex Viral Pneumonia. (a) DR demonstrates thickened and deranged lung markings in both lungs with accompanying blurry nodular shadows, and cloudy shadows in the lung fields. (b) PAS staining (400×) demonstrates eosinophilic inclusion. (c) Silver methenamine staining demonstrates herpes viral inclusion', 'hash': '9cfda956483a95dc3a4e487426e884d83e6aa0bde654b2c285ba044cf31b2a1d'}, {'image_id': '313891_1_En_17_Fig49_HTML', 'image_file_name': '313891_1_En_17_Fig49_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig49_HTML.jpg', 'caption': '(a–d) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates fan shaped shadow in the right middle lung field with its apex pointing to the hilar dense shadow, with clear boundaries. (d) CT scanning reexamination demonstrates absence of the lesions in the right lung after anti-bacteria treatment for 2 weeks', 'hash': 'f566a271be67724833f92b19b4f73190cae4216ad698f1d1a51c1d9c7579afa1'}, {'image_id': '313891_1_En_17_Fig34b_HTML', 'image_file_name': '313891_1_En_17_Fig34b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig34b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related infiltrative pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung and multiple satellite lesions scattering around. (c) CT scanning of the mediastinal window demonstrates lymphadenectasis of aortic window, subcutaneous soft tissue mass shadow in the left anterior chest wall with central low density shadow as well as right axilliary lymphadenectasis', 'hash': 'cd2bbefb6363363a2c860069ded9e79b5fabed794f0777f342cd459e7f745581'}, {'image_id': '313891_1_En_17_Fig21_HTML', 'image_file_name': '313891_1_En_17_Fig21_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig21_HTML.jpg', 'caption': '(a–c) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates enlarged right hilum in mass liked dense shadow, with peripheral thickened and blurry pulmonary markings, and no obvious abnormalities of the left hilum. (b) DR demonstrates smaller right hilum after anti-tuberculosis therapy for 1 month. (c) DR demonstrates absent tumor in the right hilum and normal left hilum', 'hash': '46a1a9267e1d610faa6450929c11c8d942047467baf49ba4482ce61bb660cb30'}, {'image_id': '313891_1_En_17_Fig27a_HTML', 'image_file_name': '313891_1_En_17_Fig27a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig27a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related miliary tuberculosis. (a–b) Anteroposterior and lateral DR demonstrates diffuse miliary shadows in both lungs, which are bilaterally symmetric and in even size and distribution. (c–f) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '61497bd4be4942d8a1fc4e6710043c9d4099da58ea99f2008d49f04ec973f2b4'}, {'image_id': '313891_1_En_17_Fig79_HTML', 'image_file_name': '313891_1_En_17_Fig79_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig79_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates multiple scattered nodular shadows in both lower lungs. (b–d) Chest CT scanning demonstrates multiple dense nodular shadows with different sizes and mass shadows in both middle and lower lung fields, with clear boundaries. They are more common in the dorsal segments', 'hash': '7f1588a4af3d4fadaf1f33e3bac3f100d4b2003206bd1bc2ae262b602fd3fe79'}, {'image_id': '313891_1_En_17_Fig51a_HTML', 'image_file_name': '313891_1_En_17_Fig51a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig51a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related staphylococcus aureus pneumonia. (a) Chest X-ray demonstrates large flaky high density shadow in the left middle-lower lung field, with central transparent areas in different sizes and blurry boundaries; parenchyma changes of the left lower lung, predominantly in the posterior and exterior basal segments; unobstructed brounchus and thickened adjacent pleura. (b–d) CT scanning demonstrates large flaky shadows in fan shaped distribution along the bronchus in the left middle-lower lung, with gas containing cavities and high density shadows; and thickened adjacent pleura of the lateral chest wall. (e, f) CT scanning of the mediastinal window demonstrates large flaky fan shaped parenchymal shadows in the left middle-lower lung field, with ventilation shadows in them; and thickened pleura of the lateral chest wall. (g, h) Pathological examination showed staphylococcus aureus', 'hash': '00d7fc70edd23ceb6f012159d4bae8563ec20a036cc91fd99d91cdbc08f23126'}, {'image_id': '313891_1_En_17_Fig90_HTML', 'image_file_name': '313891_1_En_17_Fig90_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig90_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows in the lungs that fuse into mass in parenchymal shadows, with the hilum as the center and distributing bilaterally symmetric like butterfly wings. There are also multiple clustering cavities or singular large cavity in both lungs', 'hash': '6742eff5e10355ff74a6fe215cff47247a9d12856c453a35fd6d6742f8f0ac2e'}, {'image_id': '313891_1_En_17_Fig94a_HTML', 'image_file_name': '313891_1_En_17_Fig94a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig94a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related penicillium marneffei infection. (a–f) CT scanning demonstrates multiple nodules and small cavities in honeycomb liked shadows and infiltrative parenchyma shadows in the right lung; flaky transparent areas (bullae of lung) in the right anterior margin of the heart and in the outer zone of the left lung near lateral chest wall', 'hash': '4bf177cdb556a837613a60231e962930fcd4acf34d7177f738cb57925ca917e1'}, {'image_id': '313891_1_En_17_Fig35b_HTML', 'image_file_name': '313891_1_En_17_Fig35b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig35b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related infiltrative pulmonary tuberculosis. (a) DR demonstrates diffuse large flaky dense shadows in the right upper lung with transparent areas in them. (b–c) CT scanning of the pulmonary window demonstrates large flaky shadows with increased density in the right upper lung, with multiple satellite lesions scattering around. (d, e) CT scanning of the mediastinal window demonstrates large flaky parenchymal shadows in the right upper lung with air bronchogram sign as well as mediastinal lymphadenectasis', 'hash': '8b68f2c89884110f18b2b9641154ae26362875fb18db9a64b4320edd5c13bba4'}, {'image_id': '313891_1_En_17_Fig26a_HTML', 'image_file_name': '313891_1_En_17_Fig26a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig26a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric as well as in even size and distribution', 'hash': '1bd3c2b9622fa99531543c1b9d456f58ff2945c6fa4bb44043fadb51fa9c8db6'}, {'image_id': '313891_1_En_17_Fig31_HTML', 'image_file_name': '313891_1_En_17_Fig31_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig31_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, fusion of some military shadows into patchy or mass liked shadow, diffusely distributed lung lesions', 'hash': '3bf8714e005c1ebc72eb46fac228838fd6436f0a1dd5d6a8bd085a14fddd1170'}, {'image_id': '313891_1_En_17_Fig69_HTML', 'image_file_name': '313891_1_En_17_Fig69_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig69_HTML.jpg', 'caption': '(a, b) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window in the prone posture demonstrates mass shadow and thick wall cavity shadows in the medial basal segment of the right lower lung, irregular nodular shadows in the cavities, and surrounding fused miliary infiltration shadows', 'hash': 'db839a28accf7944530e9940a7c7afb2b7b3c7a4423308b863fae87f0c08c29a'}, {'image_id': '313891_1_En_17_Fig80_HTML', 'image_file_name': '313891_1_En_17_Fig80_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig80_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a, b) Anteroposterior and lateral DR demonstrate a huge dense mass shadow in the left lower lung, with clear boundary. (c) CT scanning of the pulmonary window demonstrates round liked high density shadow in the left lower lung near left chest wall, with even density. (d) CT scanning of the mediastinal window demonstrates round liked soft tissue density shadows in the left lower lung near left chest wall, with even density, lobulation, and surrounding thick spikes', 'hash': 'ea2ef199cee39dce2b4a8a06bcdcce274a6fd8796c2efbfaf940d6d05fe48c40'}, {'image_id': '313891_1_En_17_Fig43b_HTML', 'image_file_name': '313891_1_En_17_Fig43b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig43b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related tuberculous pleuritis. (a) DR demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (b) CT scanning of the pulmonary window demonstrates thickened pleura in the right lateral chest wall in spindle liked dense shadows. (c) CT scanning of the mediastinal window demonstrates encapsulated fluid density shadow in the pleura of the right lateral chest wall', 'hash': '582e0f2e161551b97de13a60d6afed8cc613b9b04bfb136458587da830b2ecf0'}, {'image_id': '313891_1_En_17_Fig16_HTML', 'image_file_name': '313891_1_En_17_Fig16_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig16_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple fibrous cords liked shadows in lungs, multiple patchy parenchyma shadows and ground glass liked density shadows in both upper lobes, with multiple transparent areas in them. The bronchial walls are thickened in the anterior and posterior segments of the right upper lobe as well as in the lingual segment of the left lung', 'hash': '214979f5c447a9b40ebd0772cff663eb275052bf5fe8132456329ffacdc20c9c'}, {'image_id': '313891_1_En_17_Fig109_HTML', 'image_file_name': '313891_1_En_17_Fig109_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig109_HTML.jpg', 'caption': '(a, b) HIV/AIDS related lymphoma. (a, b) CT scanning demonstrates a huge soft tissue mass shadow in the left lateral chest wall, with a maximal size of about 7.7\u2009×\u200913.0 cm and occupying 30 sections with 8 mm in thickness of each section and with the upmost to the supraclavicular area and the bottom in the level of thoracic 12th vertebral body in the lower chest wall. There are also large quantity left pleural effusion and parenchymal changes of the left lower lobe with atelectasis. In the left chest cavity, large quantity liquid density shadows can be found, with compressed lung tissues to the hilum. By puncture and biopsy of the subaxillary mass, the diagnosis is defined as diffuse large B cell lymphoma', 'hash': '6d67a094843ca970dc50c93d50e7d1038c2a389c96e1772f425fa9dbc9d3a3ea'}, {'image_id': '313891_1_En_17_Fig19_HTML', 'image_file_name': '313891_1_En_17_Fig19_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig19_HTML.jpg', 'caption': '(a) Gross observation in autopsy demonstrates disseminated pulmonary tuberculosis, with grayish white military nodules in diffuse distribution in the lung tissues section. (b) It is demonstrated that mycobacteriumavium-intracellularcomplex infection in the lung tissue, with atypical tuberculosis nodules and acid-fast staining positive (left top). There are a subnodular giant cell, eosinophilic inclusion bodies in the nucleus and bradyzoites in cytoplasm of T. gondii. HE\u2009×\u2009100. (c) HE demonstrates mycobacteriumavium-intracellularcomplex infection, with atypical tuberculosis nodular changes, HE\u2009×\u2009200', 'hash': 'fac712a77d78563a8ebac012fe6c9f2f74ab72b1d36bf9e0c30462450f24c87d'}, {'image_id': '313891_1_En_17_Fig92a_HTML', 'image_file_name': '313891_1_En_17_Fig92a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig92a_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of the lesions in the right lung into plaque liked shadows with clear boundaries, and multiple round liked small cavity shadows and inflammatory infiltrative shadows in both lungs', 'hash': '981e19f8709c64fb0f850afd293a3dfdb67ec16a8d75e3f2bf19cd69116366cd'}, {'image_id': '313891_1_En_17_Fig41_HTML', 'image_file_name': '313891_1_En_17_Fig41_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig41_HTML.jpg', 'caption': 'HIV/AIDS related tuberculous pleuritis. DR demonstrates arch shaped dense shadows with higher exterior density and lower interior density in the right lower lung field and covered right edge of the heart', 'hash': '3381f76804304950a36ba44865a5651168e2f9b43c451a23d390d065bfc52e80'}, {'image_id': '313891_1_En_17_Fig56a_HTML', 'image_file_name': '313891_1_En_17_Fig56a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig56a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) DR demonstrates huge round large flaky shadows with increased density in the left lower lung, enlarged and thickened hilum and covered right heart edge. (c, d) DR reexamination after treatment for 1 week demonstrates flocculent shadow in the left lower lung, improved than those before the treatment (a, b). (e) DR reexamination after treatment demonstrates flocculent liked shadows in the left lower lung, obviously improved than before the treatment (c, d)', 'hash': '8c2f7c50d0562920efd9257451f8cc2d4dda042eaa3768d3fb1455a7092edf94'}, {'image_id': '313891_1_En_17_Fig93a_HTML', 'image_file_name': '313891_1_En_17_Fig93a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig93a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates diffuse small cavity in honeycomb liked and infiltrative parenchyma shadows, with the hilum as the center to distribute bilaterally symmetric like butterfly wings; multiple honeycomb liked cavity shadows in both lungs. (e–h) CT scanning reexamination demonstrates large irregular thick-wall cavities in the right lung, surrounding scattering nodular, honeycomba liked and infiltrative shadows after anti-PM infection treatment for 3 months', 'hash': 'eb824267db9288c03e6cffae4cde8b6f47b3bda47dcad797ee4964b9011ac598'}, {'image_id': '313891_1_En_17_Fig46b_HTML', 'image_file_name': '313891_1_En_17_Fig46b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig46b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates large flaky dense shadows in the middle-outer zone of the left middle lung field, and narrowed left bronchus. (d–f) CT scanning demonstrates large flaky shadows with uneven density in the left lateral chest wall and even lower density shadow in them', 'hash': '97eaf0337e0212b917644691da5093524803db5d92384afd57bfc5803cb125e0'}, {'image_id': '313891_1_En_17_Fig39_HTML', 'image_file_name': '313891_1_En_17_Fig39_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig39_HTML.jpg', 'caption': '(a–d) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a, b) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in the right upper lung, periphery crab feet liked or cords liked shadows due to pleural traction and satellite lesions. (c, d) CT scanning of the mediastinal window demonstrates round liked or triangle shaped thick wall cavities in the left upper lung, no nodules in the wall and peripheral nodular satellite lesions', 'hash': '614dd89032a813e240901110905f63b8b8d2530c6c7e27b0e6aab03ce47f7abb'}, {'image_id': '313891_1_En_17_Fig61_HTML', 'image_file_name': '313891_1_En_17_Fig61_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig61_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Rhodococcus equi pneumonia. (a) DR demonstrates large flaky shadow in the middle-outer zone of the left upper lung field. (b) DR demonstrates diffuse dense shadow in the left lung field, with round liked cavities shadows in them. (c–d) Reexamination after treatment demonstrates multiple cavities shadows in the middle-outer zone of the left upper lung field', 'hash': '29c84b1869c0cdabc91ee8822b014d024780586503e92fa0fdc6bed1d3b54b73'}, {'image_id': '313891_1_En_17_Fig88_HTML', 'image_file_name': '313891_1_En_17_Fig88_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig88_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a) The gross specimen demonstrates central necrotic pimples on the face. (b) Chest X-ray DR demonstrates cavities in the left upper lung, thickened lung markings in both lower lungs with accompanying multiple spots and flakes shadows. (c) Gastrointestinal barium meal radiology demonstrates left and downwards migration of the intestine due to compression. (d) Enhanced abdominal CT scanning demonstrates retroperitoneal enlarged lymph nodes that fuse into a huge mass, with ring shaped enhancement of the lymph nodes', 'hash': '72d6f61ccf9268cf07530a5a1e56a768d1d614ac854706838e783fa20f2cb2a1'}, {'image_id': '313891_1_En_17_Fig87_HTML', 'image_file_name': '313891_1_En_17_Fig87_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig87_HTML.jpg', 'caption': '(a) HE staining demonstrates lymph nodes, PM in the yeast phase, with sausage liked shape and obvious septa (HE\u2009×\u20091000). (b) GMS staining demonstrates clearly defined PMs (GMS\u2009×\u20091,000)', 'hash': '195e16d569e89c659459764942f07ae44cec9cd1fd8634e716178e34225094ab'}, {'image_id': '313891_1_En_17_Fig91a_HTML', 'image_file_name': '313891_1_En_17_Fig91a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig91a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related penicillium marneffei infection. (a–e) CT scanning demonstrates multiple small nodular shadows and small cavity shadows in the lungs, fusion of some lesions into honeycomb likes cavity shadows or plaque liked dense shadows. (f–h) CT scanning demonstrates large thick-wall cavity shadows in the right lung, surrounding plaque and round liked small cavity shadows and inflammatory infiltrative shadows', 'hash': '84aa8353e64cbf735c399fa64899ecd1e9b8a13620149a5aa662a21a423c07bf'}, {'image_id': '313891_1_En_17_Fig8b_HTML', 'image_file_name': '313891_1_En_17_Fig8b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig8b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates large flaky parenchyma shadows in both lungs which is more obvious in the middle and lower lobes of both lungs. There are also enlarged hilar shadows in both lungs and sharp both costophrenic angles. (b–g) CT scanning demonstrates large flaky parenchyma shadows in concentric and symmetrical distribution, bronchial shadows in them and thickened bronchial walls', 'hash': '812cc7d7992507bc22a7c06e518ff223d7e9ece757725f478a6f723b8ac030bf'}, {'image_id': '313891_1_En_17_Fig29_HTML', 'image_file_name': '313891_1_En_17_Fig29_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig29_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric and in even size and distribution. There are nodular shadows in the anterior segment of the right middle lung lobe with clear boundary', 'hash': '16cd873b8d84d3bbad635d9facea5407fe900b62efdd6f481449f4a433dfb6a0'}, {'image_id': '313891_1_En_17_Fig71_HTML', 'image_file_name': '313891_1_En_17_Fig71_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig71_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary aspergillosis infection. (a) The gross specimen demonstratesAspergillus abscess in the skin of the forearm. (b–d) CT scanning of the pulmonary window demonstrates multiple round liked nodular shadows and cavity shadows in both lungs, even thickness of cavity wall, and small nodular shadows in some cavities. (e) Pulmonary Aspergillus infection, demonstration purplish blue branches liked or grasses liked growth of hyphae, HE\u2009×\u2009400', 'hash': 'f0586168fbf7b2cd35205e1c807a3343af1ec5bac8dbe4f50308a570cd7d3552'}, {'image_id': '313891_1_En_17_Fig97_HTML', 'image_file_name': '313891_1_En_17_Fig97_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig97_HTML.jpg', 'caption': '(a) Gross observation of the fresh specimen in autopsy demonstrates pulmonary edema and congestion of cytomegalovirus pneumonia. (b) Gross observation of the formalin fixed specimen in autopsy demonstrates dark brown hard pulmonary tissues. (c, d) HE staining demonstrates large quantity cytomegalovirus inclusions in eagle eyes sign. (e) Immunohistochemical demonstrates HIV P24 antigen positive in macrophages of lung tissues (×400)', 'hash': '50e144edf7881be15e502fff23c2613760ac0172fe3ae6c56abf5ca1abf085b5'}, {'image_id': '313891_1_En_17_Fig20_HTML', 'image_file_name': '313891_1_En_17_Fig20_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig20_HTML.jpg', 'caption': '(a, b) HIV/AIDS related lymph node tuberculosis. (a) DR demonstrates enlarged right hilum in nodular dense shadows with peripheral thickened and blurry pulmonary markings, and no obvious abnormalities of the left hilum. (b) DR demonstrates smaller right hilum after treatment for 1 month', 'hash': '27213b483e54de634de857225fc93f6dc05eb5a729bc751141dea3866128c8ec'}, {'image_id': '313891_1_En_17_Fig6b_HTML', 'image_file_name': '313891_1_En_17_Fig6b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig6b_HTML.jpg', 'caption': '(a-d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates flaky ground glass liked density shadows in upper lobes of both lungs, with bronchial shadows in them; flaky parenchymal shadows in the subpleural apical segment; and thickened bronchial walls in the anterior and posterior segments of the right upper lobe', 'hash': 'ba6f221be2db1160358ae94e02b0125159adca1d9ac64bff84883eae8b614970'}, {'image_id': '313891_1_En_17_Fig17b_HTML', 'image_file_name': '313891_1_En_17_Fig17b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig17b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates multiple patchy parenchymal shadows and fibrous cords liked shadows in both lungs which are more obvious in both lower lungs. The trachea and bronchi are unblocked, with enlarged hilar shadows in both lungs', 'hash': 'dba27067e12ab2a752ec8a543537f427156b1a18bdc04bffa3aedbe2d3b6e7bd'}, {'image_id': '313891_1_En_17_Fig113a_HTML', 'image_file_name': '313891_1_En_17_Fig113a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig113a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Kaposi’s sarcoma. (a–d) Chest CT scanning demonstrates scattered cloudy, mass and flake liked or nodular shadows with increased density. (e) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large thick stained nucleoli, which are in line with the diagnosis of Kaposi’s sarcoma. (f–i) Cured HIV/AIDS related Kaposi’s sarcoma. (f–i) Reexamination after treatment demonstrates absent lesions in both lungs, with clear lung fields', 'hash': '192d991df0d417610162aab90c8b0e07b4c19f1436faa752263e85c3efa0f3db'}, {'image_id': '313891_1_En_17_Fig77_HTML', 'image_file_name': '313891_1_En_17_Fig77_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig77_HTML.jpg', 'caption': 'HE staining demonstrates isseminated cryptococci, the Cryptococcus is stained red after mucin carmine staining of cryptococcus neoformans spores in lungs, (HE\u2009×\u2009200)', 'hash': '882060c6f53899fb225a20d7eb5fe410195beed0a7386dc233a4632284f4717f'}, {'image_id': '313891_1_En_17_Fig78_HTML', 'image_file_name': '313891_1_En_17_Fig78_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig78_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates multiple scattered nodular and miliary shadows in both lungs. (b–d) Chest CT scanning demonstrates multiple dense nodular shadows with different sizes in both lungs, with clear boundaries. They are intensively distributed in the dorsal segment and the largest one has a diameter of about 2 cm', 'hash': 'd60cf04886c28c578ee7940f50525d5141254a1a45a5b489d53a7ae5ae27fa53'}, {'image_id': '313891_1_En_17_Fig7b_HTML', 'image_file_name': '313891_1_En_17_Fig7b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig7b_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates diffusely distributed shadows with increased density in both lungs that is more obvious in the middle and lower lungs. The hilar shadows in both lungs are enlarged. Both diaphragmatic surfaces and phrenic angles are blurry. (b–d) CT scanning demonstrates flaky shadows with increased density in both lungs, with parenchymal shadows in the lingular segment of left upper lobe and in the dorsal segments of both lower lobes and bronchial shadows in them. There are also thickened bronchial walls and enlarged hilar shadows in both lungs', 'hash': '47bf3b06e99aa6482027b30084d7445e95928d39923c99fd8fe93df39c899b2d'}, {'image_id': '313891_1_En_17_Fig30_HTML', 'image_file_name': '313891_1_En_17_Fig30_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig30_HTML.jpg', 'caption': '(a–d) HIV/AIDS related miliary tuberculosis. (a–d) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs and fusion of some military shadows, which are bilaterally symmetric and in even size and distribution', 'hash': 'ab1d4160a6a23300146e331c7eee06edf886ca73ab4514f8a59b22d04d3c303f'}, {'image_id': '313891_1_En_17_Fig1_HTML', 'image_file_name': '313891_1_En_17_Fig1_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig1_HTML.jpg', 'caption': '(a) Gross specimens’ observation demonstrates foamy liquid filling in the lung tissues. (b) HE demonstrates pneumocystis in the alveolar exudates, which can be stained black by silver methenamine staining, ×400. (c) HE demonstrates the foamy substance in the alveolar space, ×400', 'hash': 'a0082be568f7c995671d0461acf0cfe32c8c36a01dbf7badc28f3cc0ab407b75'}, {'image_id': '313891_1_En_17_Fig81_HTML', 'image_file_name': '313891_1_En_17_Fig81_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig81_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary cryptococcus infection. (a) DR demonstrates thickened lung markings in both lungs and flaky blurry shadows in the left lower lung. (b, c) CT scanning demonstrates round liked nodular and small cavity shadows in the left upper and lower lung, with clear boundaries. (d–f) Pathology demonstrates transparent substrate in lung tissues and many bi-capsular cryptococci in cytoplasm', 'hash': '3e767fbaeda72c7b7b49df4ee9daa757367932f7623507185ca8453615c8de74'}, {'image_id': '313891_1_En_17_Fig58a_HTML', 'image_file_name': '313891_1_En_17_Fig58a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig58a_HTML.jpg', 'caption': '(a–i) HIV/AIDS related Rhodococcus equi pneumonia. (a, b) CT scanning of the pulmonary window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (c, d) CT scanning of the mediastinal window before the treatment demonstrates flaky dense shadows in the dorsal segment of the left lower lung, pulmonary atelectasis and pleural effusion, with ventilation shadows in them. (e) CT scanning of the pulmonary window after the treatment demonstrates absence of the mass shadows in the left lower lung with transverse stripes shadows, obviously improved than previous findings (a, b). (f) HE staining demonstrates thickened alveolar septa and exudates from the alveolar cavity. (g) HE staining demonstrates massive bleeding in the alveolar cavity, large quantity erythrocytes and intact cell walls. (h) HE staining demonstrates phagocytized basophilic granules in the leukocytes. (i) HP staining demonstrates purplish red Rhodococcus equi in a shape of crescent in orange red sputum', 'hash': 'fcd60ca09d86084cb78d6b91f9b3e0a51e9f479a1c27837e18c9af0f809ef13d'}, {'image_id': '313891_1_En_17_Fig57_HTML', 'image_file_name': '313891_1_En_17_Fig57_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig57_HTML.jpg', 'caption': '(a, b)HIV/AIDS related Rhodococcus equi pneumonia. (a) CT scanning of the mediastinal window demonstrates soft tissue mass shadows in the dorsal segment of the left lower lung, with ventilation shadows in them. (b) CT scanning of the pulmonary window after the treatment demonstrates absence of the soft tissue mass shadows, and flocculent liked shadow in the left lower lung, obviously improved than previous findings (a)', 'hash': '9ac02a8eb30f8314fea4211fa5a4dbfa3863c422d30e78fcb26e8eaf44e36a42'}, {'image_id': '313891_1_En_17_Fig10_HTML', 'image_file_name': '313891_1_En_17_Fig10_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig10_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates large flaky and mass liked parenchyma shadows in both lungs which is more obvious in the right lung, bronchial shadows in them, and thickened bronchial walls in the middle lobe of the right lung', 'hash': 'dc81224c041dbc53a26ff01b3414f8c13098126861cf7cc0c7f10d80a7485e0c'}, {'image_id': '313891_1_En_17_Fig100_HTML', 'image_file_name': '313891_1_En_17_Fig100_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig100_HTML.jpg', 'caption': 'The structure of herpes simplex virus', 'hash': 'b0a88fbe1660ab4ddb94799e876d547c23b5686d12e31560768111a38bc71a45'}, {'image_id': '313891_1_En_17_Fig110a_HTML', 'image_file_name': '313891_1_En_17_Fig110a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig110a_HTML.jpg', 'caption': '(a–k) HIV/AIDS related Kaposi’s sarcoma. (a–c) DR demonstrates enlarged hilum in both lungs with deranged structure in bird nest liked appearance; light density flaky shadows in the lower lung fields of both lungs and small quantity pleural effusion. (d–h) CT scanning demonstrates multiple round liked nodular shadows in the middle and lower lung fields of both lungs with clear boundaries, multiple mediastinal and hilar enlarged lymph nodes. (i, j) HE staining demonstrates large quantity spindle cells or fusiform cells as well as thick stained nucleoli also in spindle shape. (k) Reexamination after treatment demonstrates no abnormalities in both lungs', 'hash': '7392286985c0e8fefacf1282d1ef323dd6d64b0b536b667dfffbcbde5be28d3c'}, {'image_id': '313891_1_En_17_Fig5b_HTML', 'image_file_name': '313891_1_En_17_Fig5b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig5b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates patchy shadows with increased density in both lungs, with thickened hilar shadows in both lungs. (b–g) CT scanning demonstrates flaky ground glass liked density shadows in upper lungs and dorsal segment of both lungs, which is more obvious in the middle inner strips. There are extrapulmonary stripes transparent shadows, with some bronchial walls thickened and enlarged hilar shadows in both lungs', 'hash': 'fcd873302d30f9846ba865346820af2a06778c5dad1b50cc634281055ae78468'}, {'image_id': '313891_1_En_17_Fig47_HTML', 'image_file_name': '313891_1_En_17_Fig47_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig47_HTML.jpg', 'caption': '(a–e) HIV/AIDS related staphylococcus aureus pneumonia. (a) DR demonstrates large flaky dense shadows with increased density in the middle-inner zone of the left upper lung field, with blurry boundaries. The lung tissue are atelectatic and the mediastinum migrates leftwards. (b, c) CT scanning demonstrates large flaky dense shadows with increased density in the middle-inner zone of the left upper lung field, with blurry boundaries, with surrounding acinar or particle liked shadows that fuse into flaky shadows. (d, e) CT scanning demonstrates large flaky shadow of parenchymal changes in the middle-inner zone of the left upper lung field, with cyst liked transparent shadows and air bronchogram sign in them, as well as mediastinal lymphadenectasis', 'hash': '8e228a648d0d33ebe1db2bfa2fa7b6209cd113683b027d6ada34f161b809085a'}, {'image_id': '313891_1_En_17_Fig48_HTML', 'image_file_name': '313891_1_En_17_Fig48_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig48_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Staphylococcus aureus pneumonia. (a–c) CT scanning demonstrates broad band liked high density shadows in the right middle lung field, with air bronchogram sign in them. (d–f) CT scanning of the mediastinal window demonstrates broad band liked uneven parenchymal shadows in the right middle lung field, with uneven thickness of air bronchogram sign', 'hash': '6e700dc830efe216b64ed069dfb6440abf50854341b133bf0237be914bd5270f'}, {'image_id': '313891_1_En_17_Fig37_HTML', 'image_file_name': '313891_1_En_17_Fig37_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig37_HTML.jpg', 'caption': '(a, b) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a, b) DR demonstrates diffuse scattering patchy shadows with increased density, and oval thin wall cavity shadows in the right middle lung field', 'hash': 'edc3511f0cc30005fb5999c1fe7033024176b0e1b8fee607763caef6a0d9abe2'}, {'image_id': '313891_1_En_17_Fig38_HTML', 'image_file_name': '313891_1_En_17_Fig38_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig38_HTML.jpg', 'caption': '(a–d) HIV/AIDS related chronic fibrous cavity pulmonary tuberculosis. (a) CT scanning of the pulmonary window demonstrates patchy shadows with increased density in both upper lungs, peripheral crab feet liked or cords liked shadows due to pleural traction with cavity shadows in them and periperal satellite lesions. (b–d) CT scanning of the mediastinal window demonstrates round liked mass shadows with high density in the cavities of the left upper lung, surrounding transparent shadows, no nodules in the walls and surrounding nodular satellite lesions. By pathological examination, the diagnosis is defined as chronic fibrous cavity pulmonary tuberculosis complicated by Aspergillus infection', 'hash': '0317a9a78d280af1069a5b797b63c3817f47607eb13976214ed710d247081a7c'}, {'image_id': '313891_1_En_17_Fig65b_HTML', 'image_file_name': '313891_1_En_17_Fig65b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig65b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related allergic pulmonary Aspergillus infection. (a–f) CT scanning of the pulmonary window demonstrates thickened central pulmonary markings in both lungs, which is turtuous and deranged with fingertip infiltration shadows. (g) DR demonstrates hyperinflation of the right lung, increased and thickened pulmonary markings and ground glass liked shadows with increased density in the right lower lung and left lung lobe', 'hash': '44f320a9216b7a9905eaaa045a44b4be59372433c9737f0ee8ded7c443134eaa'}, {'image_id': '313891_1_En_17_Fig9_HTML', 'image_file_name': '313891_1_En_17_Fig9_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig9_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a–d) CT scanning demonstrates large flaky parenchyma shadows in both lungs, with transparent areas in some foci. The trachea and bronchi are unblocked, with thickened bronchial walls in the middle and lower lobes', 'hash': '26b10397cecf70e4665c1abb0f2501e939a6e5d219f395c3484c7a44dae78681'}, {'image_id': '313891_1_En_17_Fig76a_HTML', 'image_file_name': '313891_1_En_17_Fig76a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig76a_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning demonstrates diffuse scattered thin ground glass liked, patchy, flaky blurry shadows and cords liked shadows in both lungs, with blurry boundaries and uneven density; scattered nodular shadows in different sizes; more lesions in both upper lobes and the right middle lobe; flaky parenchyma shadows in the apical and posterior segments of right upper lobe, with air bronchogram sign in them; unobstructed opening of bronchi as well as lobar and segmental bronchi without stenosis and obstruction; lymphadenectasis in the right hilar region; detected Aspergillus fumigatus by sputum culture. (e, f) Culture for 72 h, lactic acid gossypol blue staining and microscopic observation at ×200 and ×400 demonstrate short column liked conidial head, smooth wall of conidiophores, flask-shaped top capsule and monolayer microconidiophores. (g) Culture in Paul’s medium demonstrates dark green colored colonies', 'hash': '79dde610127d242cc7f1f29fc98dd50c426df080c95629396102af54f31872c9'}, {'image_id': '313891_1_En_17_Fig86_HTML', 'image_file_name': '313891_1_En_17_Fig86_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig86_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary candida infection. (a–d) CT scanning demonstrates thickened and deranged lung markings in both lungs, diffuse small flaky or patchy shadows, fusion of some small shadows into large flaky dense shadows, with blurry boundaries, enlarged hilum and blurry structures', 'hash': 'bb5525804e3b5cc6588115cd2813109845df9b4314974ab2b55c40298ed6968a'}, {'image_id': '313891_1_En_17_Fig89_HTML', 'image_file_name': '313891_1_En_17_Fig89_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig89_HTML.jpg', 'caption': '(a–d) HIV/AIDS related penicillium marneffei infection. (a–d) CT scanning demonstrates multiple small nodular shadows in the lungs that fuse into mass with parenchymal shadows, with the hilum as the center and distributing bilaterally symmetric like butterfly wings. There are also multiple clustering cavities or singular large cavity in both lungs', 'hash': 'cfd1927b986a8aba818bf96427711a3743dd07195a83b88e195837af405aae79'}, {'image_id': '313891_1_En_17_Fig60_HTML', 'image_file_name': '313891_1_En_17_Fig60_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig60_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Rhodococcus equi pneumonia. (a) DR demonstrates huge sphere liked mass shadow in the middle-outer zone of the right lower lung field, with cavities shdows in them. (b–d) CT scanning demonstrates triangular dense shadow in the middle-outer zone of the right lower lung field, with its apex pointing to the hilum and round liked cavities shadows in them. (e) Reexamination after the treatment demonstrates shrinkage of the huge sphere liked mass shadow in the middle-outer zone of the right lower lung field, with closure of the cavities', 'hash': '9020727e51b9a8522ea37dd579ce73bd9a417d327bcb313836c96e1fa3bd209f'}, {'image_id': '313891_1_En_17_Fig2b_HTML', 'image_file_name': '313891_1_En_17_Fig2b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig2b_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates scattered miliary increased density shadows in both lungs, with even size, density and distribution. The shadows of both hila are dense, with sharp both costophrenic angles. (b–f) CT scanning demonstrates scattered miliary nodular shadows in both lungs, which is more obviously in the middle pulmonary strip and with quite even size and density. Trachea and bronchi are unblocked', 'hash': 'ab808d6adb73be9c9efd977cd27ef54cace943f5143068db354c7d287374a50d'}, {'image_id': '313891_1_En_17_Fig13b_HTML', 'image_file_name': '313891_1_En_17_Fig13b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig13b_HTML.jpg', 'caption': '(a–c) HIV/AIDS related Pneumocystis carinii pneumonia. (a–c) CT scanning demonstrates multiple ground glass liked density shadows in both lungs, transparent areas in them and unblocked trachea and bronchi', 'hash': '2f728d8163ffe4c88ed77f38f8d2e52cb2281b7f3a54af1e9ef328c17a26db3e'}, {'image_id': '313891_1_En_17_Fig28_HTML', 'image_file_name': '313891_1_En_17_Fig28_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig28_HTML.jpg', 'caption': '(a–b) HIV/AIDS related miliary tuberculosis. (a) CT scanning demonstrates diffuse scattering miliary shadows with increased density in both lungs, which are bilaterally symmetric and in even size and distribution. (b) CT scanning of the mediastinal window demonstrates round liked nodular shadows in the right lower lung. CT guided puncture for biopsy is performed to define the diagnosis', 'hash': '1ae71db3f6eebb2e460b8f3b777873d5e7fcf066436bf3a85ef8123aff3f39a9'}, {'image_id': '313891_1_En_17_Fig105b_HTML', 'image_file_name': '313891_1_En_17_Fig105b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig105b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related pulmonary toxoplasmosis. (a–d) CT scanning demonstrates thickened pulmonary markings in both lungs, which can be enhanced to extend into the middle and outer zones of lungs, in grid liked appearance that is more obvious in the dorsal segment of the lungs. (e) It is demonstrated to have clustering toxoplasma tachyzoites', 'hash': '78ad5a602c243399be530b578f5858d7393984c75f2f978c1dd02f12b26b8836'}, {'image_id': '313891_1_En_17_Fig99_HTML', 'image_file_name': '313891_1_En_17_Fig99_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig99_HTML.jpg', 'caption': '(a, b) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates enlarged right hilus, thickened and deranged lung markings. (b) Plain CT scanning demonstrates mass shadows in the right hilus, spots shadows in the right middle and lower lobes, and patchy shadows in the lingual segment of the left lung', 'hash': '996d2e340f8971525deb4ef2a9312fe4a696f4d7f6bf28ca091e8c767b96b1d4'}, {'image_id': '313891_1_En_17_Fig3b_HTML', 'image_file_name': '313891_1_En_17_Fig3b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig3b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates cloudy and scattered miliary increased density shadows in both lungs, with enlarged and thickened hilum of both lungs. (b–e) CT scanning demonstrates even miliary increased density shadows in the middle and upper lungs as well as the dorsal segment of the lower lung field, with some fused in thin cloudy shadows', 'hash': '8c1d9dac035274e484303c9deb64a07fed7806c66acaf49b860164feb6d461fc'}, {'image_id': '313891_1_En_17_Fig70_HTML', 'image_file_name': '313891_1_En_17_Fig70_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig70_HTML.jpg', 'caption': '(a–d) HIV/AIDS related pulmonary aspergillosis infection. (a, b) CT scanning of the pulmonary window demonstrates a huge cavity shadow in the dorsal segment of the right lower lung, large nodular shadows in it, liquid gas level in the basal cavity, and the evenly thick wall. (c, d) CT scanning of the mediastinal window in the prone posture demonstrates a huge cavity shadow in the dorsal segment of the left lung, multiple large nodular shadows in it, and involved pleura of the lateral chest wall', 'hash': '967426acae68b8d57372efde07d76dd6ad696b10cc5bb64fb67bd9af43a1b0c8'}, {'image_id': '313891_1_En_17_Fig108_HTML', 'image_file_name': '313891_1_En_17_Fig108_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig108_HTML.jpg', 'caption': 'HIV/AIDS related lymphoma. DR demonstrates widened upper middle mediastinum in a dense shadow, enlarged and thickened hilum, thickened and blurry pulmonary markings with diffuse ground glass liked changes', 'hash': '449c992b619237febe63b1617b26f78de511c69c5d1c86ddbd66631790a3e3ce'}, {'image_id': '313891_1_En_17_Fig18_HTML', 'image_file_name': '313891_1_En_17_Fig18_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig18_HTML.jpg', 'caption': '(a–d) HIV/AIDS related Pneumocystis carinii pneumonia. (a) DR demonstrates multiple patchy shadows with increased density in both lungs which are more obvious in both middle and lower lungs. The hilar shadows in both lungs are enlarged, with sharp both costophrenic angles. (b–d) CT scanning demonstrates multiple patchy and mass liked parenchyma shadows in both lungs, ground glass density shadows in the apical segment of both upper lobes, transparent areas in the medial segment of the right middle lobe as well as in the lingual segment of the left upper lobe, and unobstructed trachea and bronchi', 'hash': '18239548bfc8a180d3460173e2f66f27c6ff38e464607d7ec3eb2a837a1382c9'}, {'image_id': '313891_1_En_17_Fig67b_HTML', 'image_file_name': '313891_1_En_17_Fig67b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig67b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and thick-wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows. (e–h) Reexamination of the pulmonary window after 3 months treatment demonstrates multiple scattered round liked nodular shadows and thick wall cavity shadows in both lungs, with small nodular shadows in the cavity shadows which obviously increase and enlarge compared to previous lesions, with accompanying infiltration shadows around the lesions', 'hash': 'f70faec5b814f1fa9555182e0f5414a33838b2496e4da16dc69e0c237676eb30'}, {'image_id': '313891_1_En_17_Fig115a_HTML', 'image_file_name': '313891_1_En_17_Fig115a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig115a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related lung cancer. (a–f) CT scanning demonstrates diffuse soft tissue density shadows in left upper lung, round liked mass shadows in the middle lung field, thickened pleura in the lateral chest wall with adhesion, and strip liked liquid density shadows', 'hash': '08de7c80ca9fdc7641723bbb9689498f65631a1a2ee1f499cda653be3ea3d358'}, {'image_id': '313891_1_En_17_Fig40_HTML', 'image_file_name': '313891_1_En_17_Fig40_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig40_HTML.jpg', 'caption': '(a, b) HIV/AIDS related endobronchial tuberculosis. (a, b) Chest CT scanning demonstrates narrowed left major bronchus, irregular thickening of the brounchial wall, multiple irregular flaky, patchy and military shadows in the posterior apical, anterior and lingual segments of the left upper lung. Bronchobierscopy demonstrates narrowed left major bronchus, which is possibly caused by endobronchial tuberculosis', 'hash': '4e416b52d4cb1a2790ee8ad419d525b4e0b37740624cb136f4f5d66c98344651'}, {'image_id': '313891_1_En_17_Fig106b_HTML', 'image_file_name': '313891_1_En_17_Fig106b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig106b_HTML.jpg', 'caption': '(a–h) HIV/AIDS related lymphoma. (a–b) DR demonstrates enlarged and thickened left hilum in a huge mass shadow. High KV demonstrates a huge mass shadow in the hilum. (c–h) CT scanning of the pulmonary window demonstrates a huge high density mass shadow in the left hilum, surrounding nodular fusion shadows in the lung tissues. CT scanning of the mediastinal window demonstrates a huge high density mass shadow in the left hilum, with air bronchogram sign in the shadow', 'hash': '157c65f2ce36513c7bad3d16abf703fde23671a6d95e1da5b62342efd5b516bb'}, {'image_id': '313891_1_En_17_Fig75a_HTML', 'image_file_name': '313891_1_En_17_Fig75a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig75a_HTML.jpg', 'caption': '(a–f) HIV/AIDS related pulmonary aspergillosis infection. (a–d) CT scanning of the pulmonary window demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval or sphere shaped nodular shadows in the cavities with smooth boundaries. (e, f) Reexamination after treatment demonstrates multiple scattered round liked nodular shadows and irregular thick-wall cavity shadows in both lungs, oval nodular shadows in the cavity with smooth boundaries. Compared to the previous imaging findings, the lesions are shrunk, with improved surrounding infiltration', 'hash': 'd2c91d61cbf8a801eed1951a78b54e9b966e9be37aee83d7582af7a496143832'}, {'image_id': '313891_1_En_17_Fig66b_HTML', 'image_file_name': '313891_1_En_17_Fig66b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig66b_HTML.jpg', 'caption': '(a–g) HIV/AIDS related pulmonary aspergillosis infection. (a) DR demonstrates large flaky shadows with increased density in the right upper lung, with blurry boundaries; round liked or sphere shaped mass shadows in the right lower lung, with uneven density. (b–e) CT scanning of the pulmonary window demonstrates multiple round liked thick-wall cavities in the dorsal segment of the right lower lung, with small nodular shadow adhering on the cavity wall; and surrounding small nodular shadows and infi ltration shadows. (f, g) Coronal CT scanning reconstruction demonstrates a huge thick-wall cavity in the right upper lung, with irregular thickness of the wall; round liked cavity shadows in the right lower lung, with thick and multilocular walls; and flaky shadows with increased density in the outer zone of the left lower lung', 'hash': 'fe0cc9e767d47fe24d043db5792869e260b44f40097a6c4d26c923e91ef70b0b'}, {'image_id': '313891_1_En_17_Fig98a_HTML', 'image_file_name': '313891_1_En_17_Fig98a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig98a_HTML.jpg', 'caption': '(a–e) HIV/AIDS related cytomegalovirus pneumonia. (a) DR demonstrates thickened lung markings in both lungs, which extend to the outer zone of the lungs. (b) DR demonstrates thickened and deranged lung markings in both lungs with nodular blurry shadows; and cloudy shadows in lung fields. (c, d) CT scanning demonstrates thickened lung markings in both lungs, with diffuse nodular shadows; and cloudy changes in lung fields. (e) HE staining demonstrates cytomegalovirus inclusions', 'hash': 'adcabf812efa2a551bb7a968e7cf0afcc7677ffb9adf3d1a40a65675496e4552'}, {'image_id': '313891_1_En_17_Fig50_HTML', 'image_file_name': '313891_1_En_17_Fig50_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig50_HTML.jpg', 'caption': '(a–f) HIV/AIDS related Staphylococcus aureus pneumonia. (a) DR demonstrates large flaky dense shadow in the right middle-upper lung field, with blurry boundary. (b, c) CT scanning demonstrates large flaky dense shadow in the right middle upper lung field, with blurry boundary. (d, e) CT scanning demonstrates large flaky dense shadow in the right middle upper lung field, with cystic transparent area in it. (f) Reexamination demonstrates obviously improved pulmonary lesions in the right lung after anti-bacteria treatment for 3 weeks', 'hash': 'bb5e00f8d7a7c6c4308ca4e5024daa75df1bf9a0a88359faa7e2ee91a6c5f156'}, {'image_id': '313891_1_En_17_Fig114a_HTML', 'image_file_name': '313891_1_En_17_Fig114a_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig114a_HTML.jpg', 'caption': '(a–h) HIV/AIDS related Kaposi’s sarcoma. (a–d) CT scanning demonstrates scattered cloudy mass and flakes liked or nodular shadows with increased density in both lungs with uneven density and unclear boundaries, fusion and parenchymal changes of some lesions, more lesions in the lower lobe of both lungs and mostly with parenchymal changes. (e, f) Pathological biopsy demonstrates large quantity heteromorphological spindle cells with large and thick stained nucleoli, which are in line with the manifestations of Kaposi’s sarcoma. (g, h) Immunohistochemical demonstrates positive of C3 and C4', 'hash': '5d7437deda7758de05e56f8172703b4659fa4eeebdc50c92456867e7bfdb2691'}, {'image_id': '313891_1_En_17_Fig107b_HTML', 'image_file_name': '313891_1_En_17_Fig107b_HTML.jpg', 'image_path': '../data/media_files/PMC7121050/313891_1_En_17_Fig107b_HTML.jpg', 'caption': '(a–e) HIV/AIDS related lymphoma. (a–e) CT scanning of the pulmonary and mediastinal windows demonstrates multiple round liked nodular shadows with increased density in both lung fields, with clear boundaries; large soft tissue mass shadows in the right lower lung, with slightly lobulated boundaries and spikes. (f–i) CT scanning of the pulmonary and mediastinal windows for reexamination after radiation therapy demonstrates shrinkage of intrapulmonary nodules and masses', 'hash': 'a7c148d3f71f853c603d1730a516c4b571960bd1e6296b96b6418a73f3663e33'}] | {'313891_1_En_17_Fig1_HTML': ['By naked eyes observation, there are extensive and diffuse invasion of lungs, which is soft like waterlogged sponge and in milky white with black spots. The filled foamy substance in the alveoli and bronchioles is a mixture of necrotic fungus and immunoglobulin. The alveolar septum has infiltration of plasma cells and lymphocytes, resulting in thickened alveolar septa up to 5–20 times as the normal thickness that occupy 3/4 of the entire lung volume. The cysts are firstly located in the macrophage cytoplasm of the alveolar septa. Subsequently, the alveolar cells containing cysts sheds off into the alveolar space. After the rupture of the cystic wall, sporozoite is discharged to turn into free trophozoites, which gains its access into the alveolar space. The alveolar exudates include plasma cells, lymphocytes and histocytes (Fig. <xref rid="313891_1_En_17_Fig1_HTML" ref-type="fig">17.1a–c</xref>).\n).\nFig. 17.1(a) Gross specimens’ observation demonstrates foamy liquid filling in the lung tissues. (b) HE demonstrates pneumocystis in the alveolar exudates, which can be stained black by silver methenamine staining, ×400. (c) HE demonstrates the foamy substance in the alveolar space, ×400\n'], '313891_1_En_17_Fig19_HTML': ['If the necrotic lesions erode the blood vessels, tubercle bacilli can cause systemic miliary tuberculosis along with blood flow, including brain, bones and kidneys. Large quantity sputum containing tubercle bacilli gains its access into the gastrointestinal tract. It can also cause intestinal tuberculosis and peritoneal tuberculosis. Pulmonary tuberculosis can cause tuberculosis pleurisy via direct spreading to the pleura (Fig. <xref rid="313891_1_En_17_Fig19_HTML" ref-type="fig">17.19a–c</xref>).\n).\nFig. 17.19(a) Gross observation in autopsy demonstrates disseminated pulmonary tuberculosis, with grayish white military nodules in diffuse distribution in the lung tissues section. (b) It is demonstrated that mycobacteriumavium-intracellularcomplex infection in the lung tissue, with atypical tuberculosis nodules and acid-fast staining positive (left top). There are a subnodular giant cell, eosinophilic inclusion bodies in the nucleus and bradyzoites in cytoplasm of T. gondii. HE\u2009×\u2009100. (c) HE demonstrates mycobacteriumavium-intracellularcomplex infection, with atypical tuberculosis nodular changes, HE\u2009×\u2009200\n'], '313891_1_En_17_Fig45_HTML': ['Pneumonia caused by inhaled staphylococcus aureus through the respiratory tract often shows lesions in the large lobes or extensive fusion of bronchopneumonia lesions. Bronchial and alveolar rupture allows gas to enter the pulmonary interstitium, which is communicated with the bronchi. In the cases of bronchiolar blockage by necrotic tissues or pus, the one-way valve effect is formed to cause tension pulmonary emphysema. In the cases with superficial pulmonary emphysema with excessively high tension, it ruptures to form pneumothorax or pyopneumothorax, as well as bronchooleural fistula (Fig. <xref rid="313891_1_En_17_Fig45_HTML" ref-type="fig">17.45a, b</xref>).\n).\nFig. 17.45(a, b) HIV/AIDS related Staphylococcus aureus pneumonia. (a) Gross specimen observation demonstrates bilateral purplish brown lesions, patchy white infiltration at the base of the lungs. (b) HE staining demonstrates alveolar diffuse lesions, exudation of the serous fluid and inflammatory cells in the alveolar cavity, and alveolar wall congestion\n'], '313891_1_En_17_Fig64_HTML': ['Aspergillus commonly violates bronchus and lung, with involvements of rhinal sinuses, external auditory canal, eye and skin. Otherwise, it disseminates to organs of the body along with blood flow. The early lesions are diffuse infiltrative and exudative changes. And advanced lesions are necrosis, pyogenesis or granuloma. Large quantity hyphae can be found in the lesions. The hyphae penetrate the blood vessels to cause vasculitis, perivascular inflammation and thrombosis. And thrombosis can cause ischemia and necrosis of the tissue. According to the pathological changes and imaging findings, it can be divided into three major types: vascular invasion type, bronchopneumonia type and allergic bronchopulmonary aspergillosis type. (1) The vascular invasion type is the result caused by toxins released in the process of aspergillus spreading extensively from the primary focus to the lungs. Vascular infiltration of the pulmonary parenchyma and coagulative necrosis are believed to be the cause of vascular occlusion and pulmonary infarction. (2) Bronchopneumonia type is acute bronchitis caused by inhalation of Aspergillus spores. In the cases of hyphae invasion into the lung tissues, extensive infiltrative pneumonia or focal granuloma are resulted in. It can also cause necrosis, pyogenesis and multiple small abscesses. Spherical pulmonary aspergillosis is often secondary to bronchiectasis, tuberculosis, carcinous cavity and other lung diseases. Mycelia multiply and gather in the cavities of the lungs to form a spherical mass with fibrin and mucosal cells, which are called aspergillar glomera, which do not invade the lung tissue. (3) Allergic bronchopulmonary aspergillosis type is the proliferation and germination of inhaled Aspergillus spore in the airway, often showing obvious related mucosal lesions and eventually resulting in bronchiectasis (Fig. <xref rid="313891_1_En_17_Fig64_HTML" ref-type="fig">17.64a–c</xref>).\n).\nFig. 17.64(a) Gross observation demonstrates dark brown lungs in appearance. (b, c) Thology demonstrates hemorrhage and edema of the lung tissue and focal necrosis, with large quantity Aspergillus hyphae and spores in the surrounding area of the necrosis (Combined with pulmonary CMV infection)\n'], '313891_1_En_17_Fig77_HTML': ['In the early stage of cryptococcal infection, only a mild inflammatory reaction or diffuse infiltrative exudative changes occur. But in the advanced stage, necrosis, suppuration or granuloma is formed. Large quantity hyphae can be found in the focus. In the cases with hyphae penetrating the blood vessels, vasculitis, perivascular inflammation and thrombosis occur. And thrombosis leads to ischemia and necrosis of the tissue (Fig. <xref rid="313891_1_En_17_Fig77_HTML" ref-type="fig">17.77</xref>).\n).\nFig. 17.77HE staining demonstrates isseminated cryptococci, the Cryptococcus is stained red after mucin carmine staining of cryptococcus neoformans spores in lungs, (HE\u2009×\u2009200)\n'], '313891_1_En_17_Fig97_HTML': ['Cytomegalovirus pneumonia has extensive pathological changes in the lungs. Pathologically, it shows interstitial pneumonia, with the lesions randomly blood borne distributing in the lungs. The distribution can be diffuse, panlobular or focal. The target cells of pathological changes include alveolar cells and macrophages. Diffused pulmonary interstitial edema and fibrosis as well as alveolar swelling, focal necrosis, bleeding and hyperplasia occur after CMV infections to cause hypoxemia. Gross observation of fresh specimens demonstrates pulmonary surface edema and flaky blooding spots. Fixed specimens demonstrate brown hard lung tissues. Under a microscope, pulmonary interstitial congestion as well as infiltration of lymphocytes and mononuclear cells can be found, with the involved epithelial cells enlarged. In the pulmonary interstitium and alveoli, there are intranuclear inclusions, cytoplasmic inclusions and fluid containing abundant proteins. The classical intranuclear inclusions can be found in the cells, purplish red or purplish blue, round or oval, with surrounding halos in eagle eyes sign. Atypical cytomegalic inclusions in cells are slender, long and round liked with abundant cytoplasm and accentric nucleolus, which are blurry, unclear and atypical (Fig. <xref rid="313891_1_En_17_Fig97_HTML" ref-type="fig">17.97a–e</xref>). Immunohistochemitry demonstrates HIV P24 antigen positive.\n). Immunohistochemitry demonstrates HIV P24 antigen positive.\nFig. 17.97(a) Gross observation of the fresh specimen in autopsy demonstrates pulmonary edema and congestion of cytomegalovirus pneumonia. (b) Gross observation of the formalin fixed specimen in autopsy demonstrates dark brown hard pulmonary tissues. (c, d) HE staining demonstrates large quantity cytomegalovirus inclusions in eagle eyes sign. (e) Immunohistochemical demonstrates HIV P24 antigen positive in macrophages of lung tissues (×400)\n']} | HIV/AIDS Related Respiratory Diseases | [
"HIV/AIDS related pneumocystis carnii pneumonia (PCP)",
"HIV/AIDS related pulmonary bacterial infections",
"HIV/AIDS related pulmonary fungal infections",
"HIV/AIDS related pulmonary virus infections",
"HIV/AIDS related pulmonary parasitic diseases",
"HIV/AIDS related pulmonary neoplasm"
] | None | 1380524400 | None | null | other | PMC7121050 | null | null | [
""
] | Radiology of HIV/AIDS. 2013 Sep 30;:377-535 | NO-CC CODE |
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